Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#446 of 11K

87631

Respiratory virus detection, 3-5 targets, multiplex

Respiratory virus detection, 3-5 targets, multiplex is the #446 most-billed Medicaid procedure code, with $220.5M in payments across 3.6M claims from 2018–2024. The national median cost per claim is $65.45. Costs vary widely — the 90th percentile is $139.16 per claim, 2.1× the median.

Total Paid

$220.5M

0.02% of all spending

Total Claims

3.6M

Providers

2K

Avg Cost/Claim

$61

National Cost Distribution

How much do providers bill per claim for 87631? Based on 2K providers billing this code nationally.

Median

$65.45

Average

$73.30

Std Dev

$60.11

Max

$877.27

Percentile Distribution (Cost per Claim)

p10
$5.67
p25
$29.09
Median
$65.45
p75
$107.56
p90
$139.16
p95
$155.18
p99
$258.42

50% of providers bill between $29.09 and $107.56 per claim for this code.

90% bill between $5.67 and $139.16.

Top 1% bill above $258.42.

About This Procedure

HCPCS code 87631 (Respiratory virus detection, 3-5 targets, multiplex) was billed by 2K providers across 3.6M claims, totaling $220.5M in Medicaid payments from 2018–2024. This code was used for 3.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$65.45

Providers Billing

2K

National Spending

$220.5M

Avg/Median Ratio

1.12×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87631

#ProviderTotal Paid
1Healthtrackrx Indiana, Inc

Denton, TX · Clinical Medical Laboratory

$16.4M
2The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$4.5M
3Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$4.4M
4Cook Children's Medical Center

Fort Worth, TX · General Acute Care Hospital Children

$4.1M
51649829987$3.9M
6Eurofins Diatherix Laboratories Llc

Huntsville, AL · Clinical Medical Laboratory

$3.9M
7Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$3.8M
8Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$3.3M
9Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$3.1M
10University Of Rochester

Rochester, NY · General Acute Care Hospital

$2.6M
11Alaska Native Tribal Health Consortium

Anchorage, AK · General Acute Care Hospital

$2.4M
12San Juan Regional Medical Center, Inc.

Farmington, NM · Audiologist

$2.2M
13Reading Hospital

West Reading, PA · Surgery

$2.0M
141982643003$1.9M
15Apple Diagnostics Lab

South Plainfield, NJ · Clinical Medical Laboratory

$1.9M
16Health Network Laboratories, Llc

Allentown, PA · Clinical Medical Laboratory

$1.8M
171194971085$1.8M
181740273994$1.8M
19University Of Kentucky

Lexington, KY · General Acute Care Hospital

$1.7M
20Accu Reference Medical Lab, Llc

Linden, NJ · Clinical Medical Laboratory

$1.6M

Showing top 20 of 2K providers billing this code