CPT code 87103: Blood culture, fungi: mold or yeast2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Culture of blood for fungal growth, including mold or yeast, with presumptive identification of isolates when fungemia or invasive fungal infection is suspected.
Medicare pays $20.46 for 87103 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
$20.46
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 87103 covers
This culture looks for mold or yeast growing from a blood specimen and includes presumptive identification of recovered isolates. It is typically performed by a clinical microbiology laboratory when the treating clinician is evaluating suspected fungemia or another invasive fungal infection. The specimen source is the key distinction from fungal cultures of skin or other sites.
Report 87103 for the fungal culture of blood; the code includes the culture and presumptive identification work. Medicare pays it through the CLFS, not the physician fee schedule. The 2026 national CLFS amount is $20.46, unchanged since 2020. Medicare uses one amount nationwide, with no locality adjustment or office-versus-facility payment difference.
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 87103
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 87103. 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 87103 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87103 on the lab fee schedule since 2020
87103 · CLFS 2026 Q4 (current)
$20.46
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.
87103 compared with similar tests
- 87101Fungal cultureSkin, hair, or nail$7.71
- Use 87101 for a fungal culture of skin. Use 87103 when the cultured specimen is blood.
- 87102Fungal cultureOther source, not blood$8.41
- 87102 is the fungal culture code for specimen sources other than blood. Select 87103 for a blood specimen.
- 87106Yeast identificationDefinitive culture identification$10.32
- 87106 describes yeast identification, while 87103 describes the blood fungal culture and includes presumptive identification of isolates.
- 87107Mold identificationEach organism$10.32
- 87107 describes mold identification, while 87103 describes the blood fungal culture and includes presumptive identification of isolates.
87103 billing questions
When should 87103 be chosen over 87102?
Use 87103 when the specimen cultured for fungi is blood. Code 87102 is used for fungal culture from other specimen sources.
How does 87103 differ from 87101?
87103 is for fungal culture of blood; 87101 is for fungal culture of skin.
Does 87103 include identification of the fungus?
The service includes presumptive identification of isolates recovered from the blood culture. Codes 87106 and 87107 describe yeast and mold identification services, respectively.
How does Medicare pay for 87103?
Medicare pays 87103 under the CLFS. The payment is one national amount, without a locality or office-versus-facility adjustment.
Is 87103 paid under the physician fee schedule?
No. Medicare pays this test through the CLFS; it is excluded from the physician fee schedule.
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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