CPT code 87301: Adenovirus antigen, enteric types 40/412026 Medicare lab fee · Clinical Laboratory Fee Schedule
Immunoassay detection of adenovirus enteric types 40/41 antigen, typically used when evaluating acute gastroenteritis, especially in children.
Medicare pays $11.98 for 87301 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 87301 covers
This test detects antigen from adenovirus enteric types 40/41 using an immunoassay, such as an enzyme or fluorescence-based assay. It is typically performed by a clinical laboratory on a stool specimen during evaluation of acute gastroenteritis, particularly in children. The result is qualitative or semiquantitative and indicates whether the targeted adenovirus antigen is detected.
Report 87301 for the adenovirus 40/41 antigen assay, rather than for a general adenovirus test or an assay targeting another infectious agent. Medicare pays the test only through the CLFS. The 2026 national CLFS amount is $11.98, unchanged since 2020; the same amount applies in every state and locality, with no office or facility payment difference. The service has no physician-fee-schedule payment.
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 87301
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 87301. 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 87301 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87301 on the lab fee schedule since 2020
87301 · 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.
87301 compared with similar tests
- 87300Polyvalent antigen testMultiple organisms, immunofluorescence$11.98
- 87300 is for polyvalent infectious-agent antigen detection. Choose 87301 when the assay specifically detects adenovirus enteric types 40/41.
- 87328Cryptosporidium antigenImmunoassay detection$13.82
- 87328 detects Cryptosporidium antigen; 87301 detects adenovirus enteric types 40/41 antigen.
- 87329Giardia antigenImmunoassay detection$11.98
- 87329 detects Giardia antigen; 87301 is specific to adenovirus enteric types 40/41.
87301 billing questions
When should 87301 be selected instead of 87300?
Use 87301 for immunoassay detection of adenovirus enteric types 40/41. Code 87300 represents polyvalent infectious-agent antigen detection, not this adenovirus-specific assay.
What specimen is typically tested?
A stool specimen is typically tested when enteric adenovirus is considered in an acute gastroenteritis evaluation.
Does this code identify adenovirus outside enteric types 40/41?
No. This code is specific to antigen detection for enteric adenovirus types 40/41; it does not represent testing for other adenovirus types.
How does Medicare pay for 87301?
Medicare pays the test through the CLFS at one national amount applicable across localities and settings. It has no physician-fee-schedule payment.
Is 87301 a polyvalent or organism-specific test?
It is organism-specific: the assay detects adenovirus enteric types 40/41 antigen. It is not a broad antigen screen for multiple infectious agents.
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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