CPT code 87290: VZV antigen test, immunofluorescent antigen detection2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Immunofluorescence testing detects varicella-zoster virus antigen in a specimen when active chickenpox or another VZV infection is evaluated.
Medicare pays $13.42 for 87290 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
$13.42
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 87290 covers
Code 87290 identifies laboratory immunofluorescence testing that detects varicella-zoster virus antigen in a specimen. It is used when active VZV infection, including chickenpox or a VZV skin eruption, is being evaluated. Lesion material collected from a skin eruption is a typical specimen. When evaluating a vesicular eruption, clinicians may consider antigen tests for herpes simplex as well, depending on the suspected cause.
Report this code for the VZV antigen test performed by immunofluorescence. Medicare pays it through the Clinical Laboratory Fee Schedule (CLFS); the 2026 national amount is $13.42, unchanged since 2020. One amount applies across states and localities, with no office-versus-facility difference. The test is excluded from the physician fee schedule by statute and 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 87290
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 87290. 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 87290 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87290 on the lab fee schedule since 2020
87290 · CLFS 2026 Q4 (current)
$13.42
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.
87290 compared with similar tests
- 87273HSV-2 antigenImmunofluorescence method$11.98
- Code 87290 detects varicella-zoster virus antigen; 87273 detects herpes simplex virus type 2 antigen by immunofluorescence.
- 87274HSV-1 antigenImmunofluorescent detection$11.98
- Code 87290 detects varicella-zoster virus antigen; 87274 detects herpes simplex virus type 1 antigen by immunofluorescence.
- 86787VZV antibody$12.88
- Code 87290 detects VZV antigen in a specimen. Code 86787 evaluates VZV antibodies and the patient's immune response.
87290 billing questions
How does this differ from a herpes simplex antigen test?
Code 87290 detects varicella-zoster virus antigen. Codes 87273 and 87274 detect herpes simplex virus type 2 and type 1 antigen, respectively.
What specimen is typically tested?
Lesion material, including cells collected from a skin eruption, is typical when evaluating suspected active VZV infection.
How does this differ from a VZV antibody test?
Code 87290 detects viral antigen in a specimen. Code 86787 evaluates VZV antibodies, which reflect the patient's immune response.
What should the documentation identify?
The documentation should support that the laboratory performed immunofluorescent testing for varicella-zoster virus antigen.
How does Medicare pay this test?
Medicare pays it through the CLFS only. The same national amount applies across localities and does not differ between office and facility settings.
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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