CPT code 86787: VZV antibody2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Varicella-zoster antibody testing measures the immune response to VZV and is reported when clinicians evaluate prior exposure or immune status.
Medicare pays $12.88 for 86787 under the 2026 Clinical Laboratory Fee Schedule: one national amount, the same in every state and setting.
Medicare lab fee · CLFS 2026 Q4
National CLFS amount
$12.88
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2020
- Unchanged
- CMS updates
- Quarterly
Medicare pays the lesser of the lab’s charge and this amount. Patients usually owe no Part B deductible or coinsurance for covered clinical lab tests.
On this page 7 sections
What 86787 covers
This laboratory assay measures antibodies to varicella-zoster virus, which causes chickenpox and shingles. Clinicians may order it to assess evidence of prior exposure or immune status. Clinical laboratories perform and report the antibody analysis; a blood serum specimen is commonly used.
Report 86787 for an assay directed at VZV antibodies, rather than a test for viral DNA. The code identifies VZV as the antibody target, not antibody testing for another pathogen. Medicare pays the test through the CLFS at one national amount in every state and locality, without geographic adjustment or an office-versus-facility difference. The 2026 national CLFS amount is $12.88, unchanged from 2020 through 2026. It is excluded from the physician fee schedule by statute and is paid only through the CLFS.
This summary was written with AI assistance from CMS Clinical Laboratory Fee Schedule data. Amounts on this page come directly from CMS files.
How Medicare pays 86787
Clinical lab tests aren’t priced like physician services. They’re paid from their own fee schedule, with its own rules. See the whole lab fee schedule.
One national amount
CMS sets a single Clinical Laboratory Fee Schedule amount for 86787. There’s no geographic (GPCI) adjustment, so it pays the same in every state and payment locality.
No office or facility rate
Lab tests aren’t built from relative value units, so there’s no office and facility split: the place of service doesn’t change the CLFS amount.
Updated every quarter
CMS republishes the CLFS each quarter. New tests, often proprietary laboratory analyses (PLA codes), join during the year; existing amounts are updated each January.
Excluded from the physician fee schedule
The physician fee schedule lists 86787 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86787 on the lab fee schedule since 2020
86787 · CLFS 2026 Q4 (current)
$12.88
Unchanged since Jan 1, 2020
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
86787 compared with similar tests
- 86762Rubella antibody$14.39
- 86762 tests for rubella antibodies. Use 86787 when the antibody target is varicella-zoster virus.
- 86765Measles antibody$12.88
- 86765 tests for rubeola (measles) antibodies, not varicella-zoster antibodies.
- 86769COVID-19 antibodyMultiple-step method$42.13
- 86769 is for SARS-CoV-2 antibodies. The target for 86787 is varicella-zoster virus.
86787 billing questions
How does this differ from a VZV molecular test?
86787 measures antibodies to varicella-zoster virus. A molecular test looks for viral genetic material rather than the antibody response.
Is this the correct code for rubella or measles antibody testing?
No. Use 86787 for antibodies to varicella-zoster virus; 86762 is for rubella antibody and 86765 is for rubeola (measles) antibody.
What specimen is commonly used?
A blood serum specimen is commonly used for VZV antibody testing.
How does Medicare pay 86787?
Medicare pays it under the CLFS at one national amount, without a locality or office-versus-facility adjustment. The test is excluded from the physician fee schedule by statute.
Where this amount comes from
FeeBase reads lab amounts directly from the CMS Clinical Laboratory Fee Schedule file for the quarter: one row per code, with its payment indicator and national amount. Contractor-priced tests are labeled, never given a made-up amount. Amounts are Medicare payment limits, not a patient’s bill or a commercial rate.
CMS CLFS 2026 Q4 · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file line behind this amount
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