CPT code 87503: Influenza NAAT, each type beyond two2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports nucleic acid detection of each additional influenza virus type or subtype tested beyond the first two in a multiplex assay.
Medicare pays $29.22 for 87503 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
$29.22
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 87503 covers
This add-on reports nucleic acid detection of an additional influenza virus type or subtype beyond the first two assessed in the primary test. The assay uses an amplified probe technique and may include multiplex reverse transcription. Clinical laboratories typically perform it on respiratory specimens when clinicians are evaluating suspected influenza infection and need testing for more than two types or subtypes.
Report 87503 for each additional influenza type or subtype tested beyond the first two, alongside the primary influenza assay, rather than as a stand-alone test. Medicare pays it only through the CLFS. The 2026 national CLFS amount is $29.22, unchanged since 2020; one amount applies nationwide, without locality or office/facility adjustment. The test 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 87503
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 87503. 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 87503 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87503 on the lab fee schedule since 2020
87503 · CLFS 2026 Q4 (current)
$29.22
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.
87503 compared with similar tests
- 87501Influenza testEach type or subtype$51.31
- Use 87501 when testing one influenza type or subtype. It does not report an additional target beyond the first two.
- 87502Influenza NAATFirst two types or subtypes$95.80
- Use 87502 for the initial two influenza types or subtypes; 87503 is added for each further type or subtype.
- 87631Respiratory virus panelThree to five targets$142.63
- 87631 represents a respiratory pathogen panel with 3–5 targets. Use 87503 when the reported service is an additional influenza target beyond the first two.
- 87632Respiratory panelSix to eleven targets$218.06
- 87632 represents a respiratory pathogen panel with 6–11 targets, rather than an add-on for each influenza type or subtype beyond two.
87503 billing questions
Which primary code is reported with 87503?
Report 87503 with 87502 when the assay evaluates additional influenza types or subtypes beyond the first two.
How many units of 87503 should be reported?
Report one unit for each additional influenza type or subtype tested beyond the first two.
When should 87501 or 87502 be used instead?
Use 87501 for testing one influenza type or subtype and 87502 for the first two. Add 87503 for each further type or subtype tested.
What should the laboratory record support?
The record should identify the influenza assay and document the additional type or subtype tested beyond the first two.
How does Medicare pay 87503?
Medicare pays the test through the CLFS at one national amount, with no locality or office/facility adjustment.
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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