CPT code 87511: Gardnerella test, amplified probe2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports an amplified nucleic acid probe test that detects Gardnerella vaginalis, commonly ordered during evaluation of vaginal symptoms or suspected bacterial vaginosis.
Medicare pays $35.09 for 87511 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 87511 covers
This laboratory test detects Gardnerella vaginalis nucleic acid using an amplified probe method. It is commonly ordered as part of an evaluation for vaginal symptoms or suspected bacterial vaginosis. A clinician may order it alongside other tests for causes of vaginitis; detection of the organism is not, by itself, a complete clinical assessment of bacterial vaginosis. The assay is performed by a clinical laboratory.
Report 87511 for the amplified probe assay, rather than a direct-probe or quantitative Gardnerella test. Medicare pays it through the CLFS and excludes it from the physician fee schedule. The 2026 national CLFS amount is $35.09, unchanged since 2020; one amount applies nationwide, without locality or office-versus-facility adjustment.
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 87511
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 87511. 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 87511 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87511 on the lab fee schedule since 2020
87511 · 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.
87511 compared with similar tests
- 87510Gardnerella testDirect probe technique$20.05
- Both codes detect Gardnerella vaginalis, but 87510 uses a direct probe method; 87511 uses an amplified probe.
- 87512Gardnerella testQuantitative nucleic acid$41.76
- 87512 reports quantitative Gardnerella testing. Choose 87511 for amplified probe detection without a quantitative result.
- 87661Trichomonas testAmplified nucleic acid$35.09
- 87661 detects Trichomonas vaginalis using an amplified probe. It targets a different organism from the Gardnerella assay reported with 87511.
87511 billing questions
How does 87511 differ from 87510?
87511 is for amplified probe detection of Gardnerella vaginalis. Use 87510 for the direct-probe method.
When should 87512 be reported instead?
87512 is the quantitative Gardnerella test. Report 87511 when the service is an amplified probe detection assay rather than quantification.
Does 87511 diagnose bacterial vaginosis by itself?
The test detects Gardnerella vaginalis. Its result should be considered with the clinical evaluation and any other testing used to assess vaginal symptoms.
How does Medicare pay for 87511?
Medicare pays the test under the CLFS and excludes it from the physician fee schedule. The national amount applies across localities and has no office-versus-facility adjustment.
What does 87511 detect?
It detects Gardnerella vaginalis using an amplified probe method.
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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