Is CPT 87635 overcharged?
87635: COVID-19 PCR test (Lab)
Approximate Medicare national rate
$51.31
Source: CMS Clinical Lab Fee Schedule CY2026 Q4 (national limit). National amount; actual Medicare payment varies by locality.
What's a reasonable charge?
Commercial insurers typically pay roughly 1.5 to 2.5 times Medicare. If you were billed more than $153.93 for 87635, ask for an itemized bill, request the provider's cash price, and dispute the difference.
Check your whole bill
Duplicates and unbundling are often worth more than a single high price. Scan your bill free