CPT code 87253: Virus culture, additional studies per isolate2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports further testing or definitive identification of a virus recovered in tissue culture, with each isolate counted separately.
Medicare pays $20.20 for 87253 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
$20.20
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 87253 covers
This service covers additional laboratory studies or definitive identification of a virus isolate recovered through tissue culture. Depending on the isolate, the work may include methods such as hemadsorption, neutralization, or immunofluorescent staining. A clinical laboratory or virology laboratory reports it when further characterization follows virus isolation; it is not the initial tissue-culture inoculation itself.
Report the service for each isolate receiving the additional study or identification. Medicare pays the code only through the CLFS. The 2026 national CLFS amount is $20.20, unchanged since 2020; the same amount applies across localities, without geographic or office/facility adjustment. There is no separate physician-fee-schedule payment for 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 87253
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 87253. 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 87253 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87253 on the lab fee schedule since 2020
87253 · CLFS 2026 Q4 (current)
$20.20
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.
87253 compared with similar tests
- 87252Virus cultureTissue culture method$26.07
- 87252 represents virus isolation by tissue-culture inoculation. 87253 represents additional studies or definitive identification of an isolate.
- 87250Virus isolationEgg or small-animal inoculation$19.56
- 87250 describes virus isolation using eggs or small animals. 87253 covers additional studies or definitive identification of an isolate in tissue culture.
- 87254Virus isolationShell vial method$19.56
- 87254 describes virus isolation using the shell-vial method. 87253 covers further studies or identification of an isolate, not the isolation method itself.
87253 billing questions
When should 87253 be reported instead of 87252?
Report 87252 for tissue-culture virus isolation. Use 87253 for additional studies or definitive identification performed on an isolate.
How are units counted?
Report one unit for each isolate receiving the additional study or definitive identification.
Which additional studies are included?
Examples include hemadsorption, neutralization, and immunofluorescent staining used for further study or definitive identification of an isolate.
Does Medicare pay a separate physician interpretation for 87253?
No. Medicare pays this test through the CLFS, and it has no separate physician-fee-schedule payment.
Does payment vary by locality or setting?
No. The CLFS amount is national and applies across localities, with no office or 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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