CPT code 87274: HSV-1 antigen, immunofluorescent detection2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This immunofluorescent assay detects HSV-1 antigen and is reported when a laboratory tests specifically for herpes simplex virus type 1.
Medicare pays $11.98 for 87274 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 87274 covers
87274 identifies HSV-1 antigen using immunofluorescence, a direct detection method. It is used when testing is directed at HSV-1 infection and the laboratory performs this method. The result identifies viral antigen rather than viral growth or an antibody response. It is distinct from HSV culture and from testing for HSV-2.
Report 87274 when the laboratory performs the HSV-1 immunofluorescent antigen test; HSV-2 antigen testing is represented by 87273. Medicare pays the test through the CLFS, with a single national amount applying across states and localities and no office or facility difference. The 2026 national amount is $11.98, unchanged from 2020 through 2026. The physician fee schedule excludes 87274 by statute, so 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 87274
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 87274. 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 87274 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87274 on the lab fee schedule since 2020
87274 · 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.
87274 compared with similar tests
- 87273HSV-2 antigenImmunofluorescence method$11.98
- Use 87274 for HSV-1 antigen and 87273 for HSV-2 antigen; both use immunofluorescence.
- 87255HSV isolationCulture with identification$33.86
- 87274 detects HSV-1 antigen directly. 87255 represents genetic identification of an HSV isolate.
- 87290VZV antigen testImmunofluorescent antigen detection$13.42
- 87290 tests for varicella-zoster antigen, whereas 87274 tests for HSV-1 antigen.
87274 billing questions
How is 87274 distinguished from 87273?
87274 is for immunofluorescent detection of HSV-1 antigen; 87273 is for HSV-2 antigen.
Does 87274 include HSV-2 testing?
No. HSV-2 antigen testing is represented by 87273.
Is 87274 a viral culture?
No. It identifies HSV-1 antigen by immunofluorescence rather than reporting viral isolation.
When would 87255 be used instead?
87255 represents genetic identification of an HSV isolate, rather than direct HSV-1 antigen detection by immunofluorescence.
How does Medicare pay for 87274?
Medicare pays it through the CLFS at one national amount across states and 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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