CPT code 87101: Fungal culture, skin, hair, or nail2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Culture of skin, hair, or nail specimens for mold or yeast, reported when a clinician evaluates a suspected fungal infection at these sites.
Medicare pays $7.71 for 87101 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
$7.71
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 87101 covers
This laboratory service cultures a skin, hair, or nail specimen to grow mold or yeast and presumptively identify the isolate. It is commonly ordered when a clinician evaluates a persistent or atypical skin rash, suspected fungal nail disease, or a scalp or hair infection. Dermatologists, primary care clinicians, and other providers may collect or submit the specimen; a clinical laboratory performs and reports the culture. The specimen source distinguishes this service from fungal cultures of blood or other sources.
Report the service for the fungal culture of the skin, hair, or nail specimen; the culture includes presumptive identification. Medicare pays it through the CLFS, with one national amount across states and localities and no office-versus-facility difference. The 2026 national CLFS amount is $7.71, unchanged since 2020. The test is paid only from the CLFS, not 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 87101
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 87101. 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 87101 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87101 on the lab fee schedule since 2020
87101 · CLFS 2026 Q4 (current)
$7.71
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.
87101 compared with similar tests
- 87102Fungal cultureOther source, not blood$8.41
- This code is specific to fungal culture of skin, hair, or nail. Choose 87102 for fungal isolation culture from other specimen sources.
- 87103Blood cultureFungi: mold or yeast$20.46
- Use this code for fungal culture of skin, hair, or nail; use 87103 when the specimen is blood.
- 87106Yeast identificationDefinitive culture identification$10.32
- 87106 identifies yeast from an isolate. This code cultures a skin, hair, or nail specimen and includes presumptive identification.
- 87107Mold identificationEach organism$10.32
- 87107 identifies mold from an isolate. This code cultures a skin, hair, or nail specimen and includes presumptive identification.
87101 billing questions
When should this code be selected instead of 87102?
Use this code for a fungal culture of skin, hair, or nail. Code 87102 is the neighboring fungal-isolation culture code for specimens outside those specified sites.
Is a blood fungal culture reported with this code?
No. A fungal culture from blood is reported with 87103; this code is for skin, hair, or nail specimens.
Does the service include organism identification?
It includes presumptive identification of the cultured isolate. Separate yeast or mold identification codes may be relevant when additional identification is performed.
Does Medicare pay this test under the physician fee schedule?
No. Medicare pays the test only through the CLFS, which uses one national amount without locality or office-versus-facility differences.
What specimen should support reporting?
The submitted specimen should be from skin, hair, or nail and be documented as the material cultured for mold or yeast.
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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