CPT code 87254: Virus isolation, shell vial method2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports centrifuge-enhanced shell-vial virus isolation with immunofluorescent identification, with one unit reported for each virus tested.
Medicare pays $19.56 for 87254 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
$19.56
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 87254 covers
Clinical laboratories perform centrifuge-enhanced virus isolation using the shell vial technique. The method uses centrifugation to enhance isolation, followed by immunofluorescent identification of the virus. This is a virus-isolation service, distinct from direct antigen detection and other virus-isolation methods. The service is reported separately for each virus tested, and the immunofluorescent identification is included.
Report one unit per virus tested. Medicare pays 87254 through the CLFS. The 2026 national CLFS amount is $19.56, unchanged since 2020. The same national amount applies in every state and locality, without geographic or office-versus-facility adjustment. The physician fee schedule excludes this test; Medicare payment is 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 87254
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 87254. 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 87254 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87254 on the lab fee schedule since 2020
87254 · CLFS 2026 Q4 (current)
$19.56
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.
87254 compared with similar tests
- 87252Virus cultureTissue culture method$26.07
- 87252 is the neighboring tissue-inoculation virus-isolation code. Choose 87254 when the service uses centrifuge-enhanced shell vial isolation.
- 87250Virus isolationEgg or small-animal inoculation$19.56
- 87250 is for virus inoculation in eggs or animals. Code 87254 is specific to the shell vial method.
- 87255HSV isolationCulture with identification$33.86
- 87255 is specific to genetic HSV isolation; 87254 reports centrifuge-enhanced shell vial isolation with immunofluorescent identification.
87254 billing questions
When should 87254 be chosen instead of 87252?
87252 is the neighboring tissue-inoculation virus-isolation code. Use 87254 for centrifuge-enhanced shell vial isolation.
How many units are reported?
Report one unit for each virus tested. Immunofluorescent identification is included.
Can immunofluorescent identification be billed separately?
No. Identification by immunofluorescence is included in the shell vial isolation service.
How does Medicare pay for 87254?
Medicare pays the test through the CLFS, at one national amount across localities and without an office-versus-facility adjustment.
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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