CPT code 87260: Adenovirus antigen, immunofluorescent detection2026 Medicare lab fee · Clinical Laboratory Fee Schedule
An immunofluorescent laboratory test detects adenovirus antigen in a clinical specimen when an organism-specific antigen result is needed.
Medicare pays $14.43 for 87260 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
$14.43
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 87260 covers
This laboratory assay detects adenovirus antigen in a clinical specimen using immunofluorescence. It reports antigen detection for adenovirus, rather than viral isolation by culture or an antibody response. Clinicians may use the result when evaluating suspected adenovirus infection. The code identifies the organism and test method; it is not a general code for every pathogen tested by immunofluorescence.
Report the code for the adenovirus antigen assay performed. Medicare pays it through the Clinical Laboratory Fee Schedule (CLFS) at one national amount across all states and localities, with no office-versus-facility payment difference. The 2026 national CLFS amount is $14.43, unchanged from 2020 through 2026. The test is paid only 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 87260
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 87260. 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 87260 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87260 on the lab fee schedule since 2020
87260 · CLFS 2026 Q4 (current)
$14.43
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.
87260 compared with similar tests
- 87276Influenza A testAntigen immunofluorescence$16.07
- This code detects influenza A antigen by immunofluorescence; 87260 is for adenovirus antigen.
- 87280RSV antigenImmunofluorescent method$13.42
- This code detects respiratory syncytial virus antigen; 87260 is specific to adenovirus antigen.
- 87271CMV antigenDirect fluorescent antibody$13.42
- This code is for cytomegalovirus detection by direct fluorescent antibody testing; 87260 detects adenovirus antigen by immunofluorescence.
87260 billing questions
When is this code appropriate instead of a viral culture code?
Use this code when the laboratory detects adenovirus antigen by immunofluorescence. Viral isolation by culture is a different laboratory method.
Is this an antibody test?
No. It detects adenovirus antigen in a specimen, rather than measuring the patient's antibody response.
Can this code be used for another virus detected by immunofluorescence?
No. This code is specific to adenovirus antigen detection; use the code corresponding to the other organism tested.
How does Medicare pay for this test?
Medicare pays the test through the CLFS at one national amount, with no geographic or office-versus-facility payment 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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