CPT code 87169: Parasite exam, visual inspection2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports laboratory visual examination of a parasite, distinguishing macroscopic inspection from microscopic ova-and-parasite smear examination.
Medicare pays $4.31 for 87169 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
$4.31
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 87169 covers
Code 87169 reports a laboratory’s macroscopic, or visual, examination of a parasite. It describes examining the parasite itself by sight, rather than examining ova-and-parasite smears microscopically. The target and method distinguish it from macroscopic examination of an arthropod (87168), a pinworm examination (87172), and ova-and-parasite smear examination (87177). These nearby services represent different examination targets or approaches.
Report 87169 for the macroscopic parasite examination performed. Medicare pays it under the CLFS at one national amount that applies across localities, with no geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $4.31, unchanged from 2020 through 2026. The code is excluded from the physician fee schedule 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 87169
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 87169. 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 87169 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87169 on the lab fee schedule since 2020
87169 · CLFS 2026 Q4 (current)
$4.31
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.
87169 compared with similar tests
- 87168Arthropod examVisual inspection$4.27
- Choose 87169 for macroscopic examination of a parasite and 87168 when the examination is of an arthropod.
- 87177Ova and parasitesSmear and concentration$8.90
- Code 87169 reports macroscopic visual examination of a parasite; 87177 reports ova-and-parasite smear examination.
- 87172Pinworm examPerianal tape preparation$4.27
- Code 87172 is for pinworm examination. Code 87169 reports macroscopic examination of a parasite.
87169 billing questions
What service does 87169 report?
It reports macroscopic, or visual, examination of a parasite.
When should 87169 be selected instead of 87177?
Use 87169 for visual examination of a parasite. Code 87177 describes ova-and-parasite smear examination.
How does 87169 differ from 87168?
Code 87169 is for macroscopic examination of a parasite; 87168 is for macroscopic examination of an arthropod.
Is 87169 the code for a pinworm examination?
No. Code 87172 is the pinworm examination code; 87169 describes macroscopic examination of a parasite.
How does Medicare pay for 87169?
Medicare pays one national CLFS amount across localities, without an office-versus-facility adjustment. The code is paid only through the CLFS.
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
Fee sheets · Coming soon
Put 87169 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist