CPT code 87481: Candida DNA test, amplified probe2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Amplified-probe testing detects Candida species DNA and is reported when a laboratory performs this test to evaluate suspected Candida infection.
Medicare pays $35.09 for 87481 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
$35.09
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 87481 covers
87481 identifies an amplified-probe nucleic-acid test for Candida species, a group of yeasts. The assay detects Candida DNA and is reported when the laboratory performs amplified-probe testing to evaluate suspected Candida infection. It differs from direct-probe Candida DNA detection and from quantitative Candida DNA testing. The code identifies the Candida target group; it does not, by itself, indicate identification of a particular species.
Medicare pays 87481 under the Clinical Laboratory Fee Schedule (CLFS). The CLFS applies one national amount in every state and locality, with no office-versus-facility payment difference. The 2026 national CLFS amount is $35.09, unchanged from 2020 through 2026. The test is paid through the CLFS and is excluded from 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 87481
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 87481. 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 87481 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87481 on the lab fee schedule since 2020
87481 · CLFS 2026 Q4 (current)
$35.09
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.
87481 compared with similar tests
- 87480Candida probeDirect probe$20.05
- Choose 87481 for amplified-probe detection of Candida DNA; 87480 represents direct-probe detection.
- 87482Candida DNAQuantitative measurement$55.74
- 87482 is for quantitative Candida DNA testing. 87481 represents amplified-probe detection rather than quantitative testing.
- 87102Fungal cultureOther source, not blood$8.41
- 87102 represents fungal culture. Use 87481 when the laboratory performs Candida DNA detection with an amplified probe instead.
87481 billing questions
How does 87481 differ from 87480?
87481 represents amplified-probe detection of Candida DNA. 87480 represents direct-probe detection.
When would 87482 be considered instead?
87482 is for quantitative Candida DNA testing. 87481 represents amplified-probe detection.
Does 87481 identify a particular Candida species?
The code represents detection of Candida species DNA by amplified probe; it does not itself indicate that a particular species was identified.
Does 87481 quantify Candida DNA?
No. 87481 represents amplified-probe detection; 87482 represents quantitative Candida DNA testing.
How does Medicare pay for 87481?
Medicare pays 87481 through the CLFS at one national amount across localities, without an 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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