CPT code 87506: GI pathogen panel, 6–11 targets2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports multiplex nucleic-acid testing of gastrointestinal pathogens across 6–11 targets when evaluating suspected infectious diarrhea or gastroenteritis.
Medicare pays $262.99 for 87506 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
$262.99
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 87506 covers
This panel uses multiplex nucleic-acid testing to detect gastrointestinal pathogens across 6–11 targets. The method uses amplified probes and may include reverse transcription. Targets can include organisms such as Clostridioides difficile, pathogenic Escherichia coli, Salmonella, Shigella, norovirus, and Giardia. Stool is the typical specimen when evaluating infectious diarrhea or gastroenteritis. Clinical laboratories perform these tests on specimens ordered by clinicians in outpatient and other care settings.
Select the code by the number of targets included in the assay, not the number detected in the patient. Medicare pays for the test through the CLFS; it is excluded from the physician fee schedule. The 2026 national CLFS amount is $262.99, unchanged since 2020. The same amount applies across localities and in office or facility settings.
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 87506
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 87506. 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 87506 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87506 on the lab fee schedule since 2020
87506 · CLFS 2026 Q4 (current)
$262.99
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.
87506 compared with similar tests
- 87505GI pathogen panelThree to five targets$128.29
- Use 87505 for a gastrointestinal pathogen assay testing 3–5 targets; use 87506 for 6–11.
- 87507GI pathogen panel12–25 targets$416.78
- Use 87507 for a gastrointestinal pathogen assay testing 12–25 targets; use 87506 for 6–11.
- 87493C. difficile testToxin-gene amplification$37.27
- 87493 is focused nucleic-acid testing for C. difficile. Use 87506 for a multiplex gastrointestinal panel with 6–11 targets.
87506 billing questions
How does this code differ from 87505 and 87507?
Choose among these related GI panel codes by the assay's target count: 87505 covers 3–5 targets, 87506 covers 6–11, and 87507 covers 12–25.
Is the target count based on positive results?
No. Select the code based on how many targets the assay tests, not how many are detected in the specimen.
What specimen is typically tested?
Stool is the typical specimen for a multiplex gastrointestinal pathogen panel used to investigate infectious diarrhea or gastroenteritis.
Can this be reported with a focused C. difficile test?
A focused C. difficile nucleic-acid test, such as 87493, may be used instead when the order is limited to that organism. Report services according to the tests performed.
How does Medicare pay this test?
Medicare pays 87506 under the CLFS, with the same national amount across localities and in office or facility settings.
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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