CPT code 87086: Urine culture, quantitative colony count2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports bacterial growth quantified by colony count in a urine culture, commonly ordered when evaluating a patient for a urinary tract infection.
Medicare pays $8.07 for 87086 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
$8.07
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 8 sections
What 87086 covers
This test cultures a urine specimen and quantifies bacterial growth by colony count. Clinicians commonly order it when evaluating symptoms or findings that raise concern for a urinary tract infection. Clinical microbiology laboratories perform and report the culture, including in outpatient and hospital settings.
Report 87086 for the quantitative colony count on each urine specimen cultured. When additional urine culture work includes isolation and presumptive identification of organisms, 87088 may also be reported. Medicare pays 87086 only under the Clinical Laboratory Fee Schedule (CLFS). The 2026 national CLFS amount is $8.07, unchanged since 2020; the same amount applies across states and localities, without an office or facility difference. The test is excluded from the physician fee schedule.
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 87086
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 87086. 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 87086 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87086 on the lab fee schedule since 2020
87086 · CLFS 2026 Q4 (current)
$8.07
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.
87086 compared with similar tests
- 87088Urine cultureIsolate identification$8.09
- Choose 87086 for the quantitative urine colony count. Use 87088 for urine culture work involving isolation and presumptive identification of each isolate; both may be reported when both services are performed.
- 87070Aerobic cultureNon-urine, blood, or stool$8.62
- 87070 is for aerobic bacterial culture of a specimen other than urine. Use 87086 for a urine specimen when reporting its quantitative colony count.
- 87040Blood cultureBacterial culture$10.32
- 87040 is for bacterial culture of blood. Use 87086 for quantitative colony counting from urine.
87086 billing questions
What does 87086 report?
It reports a bacterial colony count from a urine culture. The result quantifies bacterial growth in the specimen.
How is 87086 different from 87088?
87086 reports the quantitative colony count. 87088 reports urine culture work involving isolation and presumptive identification of each isolate.
Can 87086 and 87088 be reported for the same specimen?
They may be reported together when the urine culture includes both quantitative colony counting and the additional work represented by 87088.
What is the unit of service for 87086?
Report one service for each urine specimen cultured for quantitative colony count.
Which code is used for a blood culture instead?
87040 reports bacterial culture of a blood specimen; 87086 is specific to quantitative colony counting in urine.
How does Medicare pay 87086?
Medicare pays the test through the CLFS at one national amount, with no geographic or office-versus-facility adjustment.
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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