CPT code 87272: Cryptosporidium test, immunofluorescent antigen detection2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Immunofluorescent testing detects Cryptosporidium antigen, typically in stool evaluated for suspected cryptosporidiosis causing acute or persistent diarrhea.
Medicare pays $11.98 for 87272 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
$11.98
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 87272 covers
This test detects Cryptosporidium antigen using immunofluorescence. A clinical microbiology laboratory typically performs it on stool when a clinician evaluates acute or persistent watery diarrhea and suspects cryptosporidiosis, including when contaminated-water exposure or an outbreak is a concern. The assay targets Cryptosporidium; it is distinct from a broad stool ova-and-parasite examination and does not identify other enteric pathogens.
Report 87272 when the laboratory performs Cryptosporidium antigen detection by immunofluorescence. Choose a different code when the laboratory uses another method. Medicare pays the test through the CLFS, with one national amount per code across localities and no office-versus-facility difference. The 2026 national CLFS amount is $11.98, unchanged each year from 2020 through 2026. The test is paid through the CLFS rather than 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 87272
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 87272. 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 87272 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87272 on the lab fee schedule since 2020
87272 · CLFS 2026 Q4 (current)
$11.98
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.
87272 compared with similar tests
- 87269Giardia antigenImmunofluorescent detection$13.61
- Both use immunofluorescence to detect parasite antigen, but 87269 is for Giardia and 87272 is for Cryptosporidium.
- 87328Cryptosporidium antigenImmunoassay detection$13.82
- This code is for Cryptosporidium antigen testing using a different immunoassay method; 87272 is specific to immunofluorescence.
- 87177Ova and parasitesSmear and concentration$8.90
- 87177 represents a broader ova-and-parasite examination. Use 87272 for the targeted Cryptosporidium immunofluorescent antigen test.
87272 billing questions
How is 87272 different from the Giardia antigen test?
87272 identifies Cryptosporidium antigen by immunofluorescence. Use 87269 for Giardia antigen testing by immunofluorescence.
What specimen is typically tested?
Stool is the typical specimen for evaluating suspected intestinal cryptosporidiosis.
Does 87272 represent a full ova-and-parasite examination?
No. It represents a targeted Cryptosporidium immunofluorescent antigen test, not a broad examination for parasites.
How should the laboratory method be documented?
Documentation should support Cryptosporidium antigen detection by immunofluorescence and identify the tested specimen.
How does Medicare pay 87272?
Medicare pays it through the CLFS at one national amount across localities, without an 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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