CPT code 87449: Other antigen test, each organism, unspecified target2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Qualitative or semiquantitative immunoassay detection of an infectious-agent antigen not otherwise specified, reported separately for each organism tested.
Medicare pays $11.98 for 87449 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
- QW · CLIA-waived test
- $11.98
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 87449 covers
This code represents immunoassay detection of an infectious-agent antigen when a more specific antigen code does not describe the target. The assay produces a qualitative or semiquantitative result and is counted separately for each organism. Clinical laboratories perform the test; a CLIA-waived version may be performed by an office or other site holding a CLIA certificate of waiver. Methods include enzyme-based and fluorescence immunoassay techniques. This code is for an antigen target without a dedicated organism-specific code, rather than a polyvalent multiple-organism assay.
Report one unit per organism tested. Modifier QW identifies the CLIA-waived version when performed by a site holding a CLIA certificate of waiver. Medicare pays the test under the CLFS only. The 2026 national CLFS amount is $11.98, unchanged from 2020 through 2026; the amount is the same across localities, with no geographic or office/facility adjustment.
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 87449
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 87449. 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 87449 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 87449 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $11.98.
87449 on the lab fee schedule since 2020
87449 · 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.
87449 compared with similar tests
- 87451Antigen detectionMultiple organisms, polyvalent$10.51
- 87451 describes polyvalent antigen testing involving multiple organisms. 87449 is for an otherwise-unspecified organism and is reported for each organism tested.
- 87420RSV antigenImmunoassay method$13.91
- 87420 is specific to respiratory syncytial virus antigen testing. Use 87449 for an antigen target not represented by a more specific code.
- 87426Coronavirus antigenQualitative or semiquantitative$35.33
- 87426 is specific to SARS-CoV-2 antigen testing. 87449 is the nonspecific-organism option, not the code for a named SARS-CoV-2 target.
- 87430Strep A antigenImmunoassay detection$16.81
- 87430 identifies group A streptococcus antigen testing. 87449 applies when the organism tested is not covered by a more specific antigen code.
87449 billing questions
When should 87449 be used instead of an organism-specific antigen code?
Use 87449 when the antigen immunoassay is for an organism not otherwise specified by a more specific code. For a named target such as respiratory syncytial virus or group A streptococcus, use the corresponding organism-specific code.
How many units are reported?
Report the code for each organism tested. It does not describe a polyvalent, multiple-organism test.
When is modifier QW relevant?
Use QW for the CLIA-waived version when performed by a site holding a CLIA certificate of waiver.
Does Medicare pay 87449 under the physician fee schedule?
No. Medicare pays for this test through the CLFS, using one national amount across localities and without an office or facility adjustment.
What documentation supports reporting this code?
Document the organism tested and that the service was a qualitative or semiquantitative antigen-detection immunoassay. The record should support reporting the test for each organism.
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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