CPT code 87505: GI pathogen panel, three to five targets2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Multiplex nucleic acid testing detects three to five gastrointestinal pathogen targets and is reported when an assay covers that target range.
Medicare pays $128.29 for 87505 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
$128.29
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 87505 covers
This assay uses multiplex nucleic acid methods to detect three to five gastrointestinal pathogen types or subtypes. Targets may include Clostridium difficile, Escherichia coli, Salmonella, Shigella, norovirus, or Giardia. The method uses amplified probes and may include reverse transcription when needed. Clinical laboratories perform or report the test when evaluating suspected infectious disease involving the digestive tract.
Select 87505 according to the assay’s total target count, not the number of organisms detected in an individual result; use 87506 for six to 11 targets and 87507 for 12 to 25. Medicare pays the test only through the CLFS. The 2026 national CLFS amount is $128.29 and has remained unchanged since 2020; the same amount applies across localities, with no office-versus-facility adjustment. The code is excluded from the physician fee schedule by statute.
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 87505
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 87505. 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 87505 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87505 on the lab fee schedule since 2020
87505 · CLFS 2026 Q4 (current)
$128.29
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.
87505 compared with similar tests
- 87506GI pathogen panel6–11 targets$262.99
- Use 87506 for a multiplex gastrointestinal pathogen assay with six to 11 targets; 87505 covers three to five.
- 87507GI pathogen panel12–25 targets$416.78
- Use 87507 for a panel with 12 to 25 targets; 87505 covers three to five.
- 87045Stool cultureAerobic, Salmonella and Shigella$9.44
- 87045 is a bacterial culture code, while 87505 is for multiplex nucleic acid testing. Select according to the method performed.
87505 billing questions
Which assays fit 87505?
Use 87505 for a multiplex gastrointestinal pathogen assay covering three to five targets. The assay’s target range, rather than which organisms are detected in a particular patient, determines the code.
How does 87505 differ from 87506 and 87507?
87505 covers three to five targets, 87506 covers six to 11, and 87507 covers 12 to 25.
Is 87505 the same as a bacterial stool culture?
No. 87505 describes multiplex nucleic acid testing; 87045 is a bacterial culture code. Select the code that matches the method performed.
How does Medicare pay 87505?
Medicare pays 87505 through the CLFS only. Its national amount applies across localities without an office-versus-facility adjustment.
Does 87505 identify one specific pathogen?
No. It represents a gastrointestinal pathogen assay covering three to five targets; the particular targets depend on the assay.
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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