CPT code 87172: Pinworm exam, perianal tape preparation2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Microscopic examination of a perianal tape preparation for pinworm eggs, typically ordered when Enterobius infection is suspected.
Medicare pays $4.27 for 87172 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
$4.27
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 87172 covers
Pinworm testing looks for Enterobius vermicularis eggs by examining an adhesive-tape preparation microscopically. The tape is pressed against the skin around the anus, commonly collected at home or in a clinic and sent to a clinical laboratory. Testing is often ordered for suspected pinworm infection, including perianal itching, particularly at night. A stool ova-and-parasite examination is broader and is not the same targeted perianal test.
Report 87172 for the pinworm-specific examination. Medicare pays it through the CLFS only; the 2026 national amount is $4.27 and has remained unchanged since 2020. The amount is the same across states and localities, with no geographic adjustment or office-versus-facility difference. The physician fee schedule excludes this test.
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 87172
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 87172. 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 87172 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87172 on the lab fee schedule since 2020
87172 · CLFS 2026 Q4 (current)
$4.27
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.
87172 compared with similar tests
- 87177Ova and parasitesSmear and concentration$8.90
- Choose 87172 for pinworm eggs sought on perianal tape. Choose 87177 for a broader ova-and-parasite smear examination.
- 87169Parasite examVisual inspection$4.31
- 87172 examines a tape preparation microscopically for pinworm eggs; 87169 is used for macroscopic examination of a parasite specimen.
- 87168Arthropod examVisual inspection$4.27
- 87168 is for macroscopic examination of an arthropod specimen. It is not the code for microscopic pinworm egg testing on perianal tape.
87172 billing questions
When should 87172 be used instead of 87177?
Use 87172 for a perianal tape preparation examined for pinworm eggs. Code 87177 describes a broader ova-and-parasite smear examination.
What specimen is examined?
The test examines adhesive tape applied to skin around the anus for pinworm eggs. It is not a stool smear or an examination of a recovered adult parasite.
How does 87172 differ from 87169?
Code 87172 is the targeted microscopic examination for pinworm eggs on a perianal tape preparation. Code 87169 is for macroscopic examination of a parasite specimen.
How does Medicare pay for 87172?
Medicare pays the test through the CLFS. The national amount is uniform across localities and settings.
What should the laboratory record?
Document the pinworm testing indication, the perianal tape preparation examined, and the examination result.
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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