Lab & pathology
87635 — COVID-19 PCR test
Molecular detection of SARS-CoV-2. PHE-era required to be free; post-PHE may have cost-share.
- Typical setting: Lab, doctor's office, or testing site
- National avg charge (illustrative): Insurance allowed $50-$150; cash $50-$200.
- Most-disputed reason: Charged after federal coverage requirement expired.
What it means
What 87635 actually means
CPT 87635 is the molecular PCR test for SARS-CoV-2 (COVID-19). During the federal Public Health Emergency, insurers were required to cover this at $0 cost-share. Post-PHE rules vary by plan.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Charged at hospital outpatient pricing when reference-lab pricing was available.
- Both PCR (87635) and antigen (87811) billed for the same sample.
If you see 87635 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 87635 often also see these adjacent codes on the same bill.
CPT
80050 — General health panel; includes CBC w/diff, CMP, TSH
Lab — check for unbundling and duplicate billing.
CPT
80051 — Electrolyte panel; CO2, chloride, potassium, sodium
Lab — check for unbundling and duplicate billing.
CPT
80053 — Comprehensive metabolic panel
If individual blood tests are also on your bill, you may have an unbundling error.
CPT
80055 — Obstetric panel; CBC w/diff, HBsAg, rubella Ab, syphilis, RBC Ab screen, ABO/Rh
Lab — check for unbundling and duplicate billing.
CPT
80061 — Lipid panel (cholesterol)
If you see HDL or LDL listed separately next to 80061, that's unbundling.
Related BillBusted guides
Plain-English reads if you see 87635 on a bill.
87635 FAQ
Plain-English answers.
Don't pay 87635 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.