CPT code 87207: Special stain, inclusion bodies or parasites2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A laboratory examines a specially stained smear from a primary source to identify inclusion bodies or parasites such as malaria organisms or coccidia.
Medicare pays $5.99 for 87207 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
$5.99
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 87207 covers
Code 87207 reports a specially stained smear prepared from a primary source and examined for inclusion bodies or parasites. Examples include malaria organisms, coccidia, microsporidia, trypanosomes, and herpes viruses. Clinical microbiology laboratories perform the staining and microscopic examination; a physician may provide a separately reportable professional interpretation. This differs from a Gram-stained smear (87205), a fluorescent or acid-stained smear (87206), a complex-stain smear (87209), and a saline or ink wet mount (87210).
The laboratory test is paid under the CLFS at one national amount, with no locality or office/facility adjustment; the 2026 national amount is $5.99, unchanged since 2020. The test itself is excluded from the physician fee schedule. A separate physician interpretation is payable under the physician fee schedule when billed with modifier 26.
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 87207
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 87207. 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 87207 with status X (excluded by statute), so the test itself is paid only from the CLFS.
Physician interpretation (modifier 26)
A physician’s interpretation is billed separately with modifier 26 and paid under the physician fee schedule: $17.70 nationally in the office, before locality adjustment.
87207 on the lab fee schedule since 2020
87207 · CLFS 2026 Q4 (current)
$5.99
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.
87207 compared with similar tests
- 87205Gram stainPrimary-source smear$4.27
- 87205 is for a smear examined with a Gram stain. Choose 87207 for a special stain directed at inclusion bodies or parasites.
- 87206Microbial smearFluorescent or acid-fast$5.39
- 87206 describes a fluorescent or acid stain smear. Choose 87207 when the service is a special stain for inclusion bodies or parasites.
- 87209Parasite stainComplex special stain$17.98
- 87209 is for a complex-stain smear. Choose 87207 when the documented special stain is directed at inclusion bodies or parasites.
87207 billing questions
When should this code be chosen instead of a Gram stain?
Use this code when the smear receives a special stain to look for inclusion bodies or parasites. A smear examined using a Gram stain is reported with 87205.
Can the physician interpretation be billed separately?
Yes. A separate physician interpretation is payable under the physician fee schedule when reported with modifier 26.
Does the CLFS amount vary by locality or setting?
No. Medicare pays one national CLFS amount for the code across localities, with no office or facility difference.
What should the laboratory record support?
Document the primary-source smear, the special stain, and the target being evaluated, such as parasites or inclusion bodies.
Is this the right code for a fluorescent or acid stain?
Use 87206 when the service is a fluorescent or acid stain smear. This code describes a special stain for inclusion bodies or parasites.
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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