CPT code 87427: Shiga toxin test, antigen immunoassay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
An immunoassay that detects Shiga-like bacterial toxin, commonly used on stool when evaluating suspected Shiga toxin-producing E. coli infection.
Medicare pays $11.98 for 87427 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 87427 covers
This laboratory test detects Shiga-like toxin, a bacterial toxin, using an immunoassay. It is commonly performed on stool during evaluation of acute diarrhea, particularly when Shiga toxin-producing E. coli is suspected. Clinical laboratories report a qualitative or semiquantitative result; the assay detects toxin rather than identifying the bacterium itself.
Report this code for the Shiga-like toxin immunoassay performed. The 2026 national CLFS amount is $11.98 and has remained unchanged since 2020. Medicare pays one amount per code nationwide, without locality or office-versus-facility adjustment. The test is paid through the CLFS, not 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 87427
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 87427. 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 87427 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87427 on the lab fee schedule since 2020
87427 · 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.
87427 compared with similar tests
- 87449Other antigen testEach organism, unspecified target$11.98
- 87427 identifies an immunoassay specifically for Shiga-like toxin. 87449 is the general antigen immunoassay code for an infectious agent when a more specific code is not used.
- 87451Antigen detectionMultiple organisms, polyvalent$10.51
- 87427 is for a toxin-specific immunoassay. 87451 describes a polyvalent antigen assay directed at multiple organisms.
- 87507GI pathogen panel12–25 targets$416.78
- 87427 detects Shiga-like toxin by immunoassay. 87507 is a multiplex nucleic-acid test for multiple gastrointestinal pathogens.
87427 billing questions
What does this assay detect?
It detects Shiga-like bacterial toxin by immunoassay. It does not identify the organism by itself.
When is this code used instead of a general antigen code?
Use this code for an assay specifically detecting Shiga-like toxin. Code 87449 is for an infectious-agent antigen test without a more specific code.
Is this the same as a gastrointestinal pathogen panel?
No. This code represents a toxin immunoassay; a multiplex nucleic-acid panel such as 87507 tests for multiple gastrointestinal pathogens.
What specimen is typically tested?
Stool is commonly tested when Shiga toxin-producing E. coli is suspected.
How does Medicare pay for this test?
Medicare pays it through the CLFS at one national amount, regardless of locality or office versus facility setting. It is paid only through the CLFS.
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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