CPT code 87252: Virus culture, tissue culture method2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports viral isolation by inoculating tissue culture and observing for cytopathic effects to support presumptive identification of a virus.
Medicare pays $26.07 for 87252 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
$26.07
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 87252 covers
This laboratory service uses tissue culture to attempt viral isolation from a submitted specimen. The laboratory inoculates tissue culture, observes it for cytopathic effects, and uses those changes for presumptive identification. This is a culture-based isolation method, distinct from antigen detection and egg or animal inoculation. The laboratory performs and reports the culture work.
Report 87252 for tissue-culture viral isolation. Report 87253 as the add-on for each additional specimen undergoing tissue-culture viral isolation. Medicare pays this test only through the CLFS. The CLFS provides one national amount across states and localities, with no office-versus-facility difference. The 2026 national CLFS amount is $26.07, unchanged from 2020 through 2026. Code 87252 is excluded from 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 87252
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 87252. 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 87252 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87252 on the lab fee schedule since 2020
87252 · CLFS 2026 Q4 (current)
$26.07
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.
87252 compared with similar tests
- 87253Virus cultureAdditional studies per isolate$20.20
- Use 87252 for tissue-culture viral isolation; 87253 is the add-on for each additional specimen undergoing that work.
- 87250Virus isolationEgg or small-animal inoculation$19.56
- Choose 87250 when viral isolation uses egg or animal inoculation. Use 87252 for tissue-culture inoculation.
- 87254Virus isolationShell vial method$19.56
- 87254 identifies the shell-vial viral isolation method; 87252 describes tissue-culture inoculation and observation.
- 87260Adenovirus antigenImmunofluorescent detection$14.43
- 87260 detects adenovirus antigen, while 87252 reports culture-based viral isolation with observation for cytopathic effects.
87252 billing questions
How does 87252 differ from 87250?
87252 describes viral isolation using tissue culture. 87250 is used for viral isolation using egg or animal inoculation.
When is 87253 reported with 87252?
87253 is the add-on for each additional specimen undergoing tissue-culture viral isolation. Report 87252 for the tissue-culture isolation service.
Is 87252 a culture code or an antigen test?
It reports tissue-culture inoculation, observation for cytopathic effects, and presumptive identification. Antigen detection codes describe a different testing approach.
How does Medicare pay for 87252?
Medicare pays 87252 through the CLFS only. The code is excluded from the physician fee schedule.
Does the CLFS amount vary by location or setting?
No. Medicare uses one national amount for 87252 across states and localities, with no office-versus-facility difference.
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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