CPT code 87480: Candida probe, direct probe2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A direct-probe nucleic acid test detects Candida species and is reported when the laboratory performs this method rather than amplification or quantification.
Medicare pays $20.05 for 87480 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
$20.05
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 87480 covers
This laboratory test detects Candida species using a direct-probe nucleic acid method. It identifies Candida detection rather than providing a quantitative result. The code distinguishes this method from Candida amplification and quantitative testing, so selection follows the method the laboratory performs.
Report 87480 for direct-probe Candida detection rather than the sibling codes for amplified or quantitative testing. Medicare pays the test through the CLFS, with one national amount that applies across localities and no office-versus-facility payment difference. The 2026 national CLFS amount is $20.05, unchanged from 2020 through 2026. The service 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 87480
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 87480. 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 87480 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87480 on the lab fee schedule since 2020
87480 · CLFS 2026 Q4 (current)
$20.05
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.
87480 compared with similar tests
- 87481Candida DNA testAmplified probe$35.09
- Both codes detect Candida, but 87480 is for a direct probe and 87481 is for an amplified probe. Follow the laboratory method.
- 87482Candida DNAQuantitative measurement$55.74
- 87480 reports direct-probe Candida detection; 87482 is used for quantitative Candida testing.
- 87510Gardnerella testDirect probe technique$20.05
- 87510 tests for Gardnerella, a different organism. Use 87480 for direct-probe Candida detection.
87480 billing questions
When should 87480 be selected instead of 87481?
Use 87480 when the laboratory performs a direct probe for Candida. Use 87481 for amplified-probe detection.
How does 87480 differ from 87482?
87480 describes direct-probe detection of Candida, while 87482 is for quantitative Candida testing. Select the code that matches the method and result reported.
What does 87480 report?
It reports detection of Candida species by a direct-probe method, not a quantitative result.
Can Gardnerella or Trichomonas testing be reported with 87480?
These are tests for different organisms and may be reported when each assay is performed. Code 87510 identifies Gardnerella testing, and 87660 identifies Trichomonas testing.
How does Medicare pay for 87480?
Medicare pays 87480 through the CLFS using one national amount across localities, with no office-versus-facility payment 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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