CPT code 87513: H. pylori resistance, clarithromycin, amplified probe2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Amplified nucleic acid testing detects H. pylori clarithromycin resistance, providing resistance information when clinicians assess treatment options for H. pylori infection.
Medicare pays $35.09 for 87513 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 2025
- 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 7 sections
What 87513 covers
Code 87513 describes nucleic acid detection of Helicobacter pylori clarithromycin resistance using an amplified probe technique. It reports molecular resistance information, not a quantified H. pylori burden. Clinicians use the result to inform treatment selection when clarithromycin is being considered for H. pylori infection. The clinical laboratory performs the assay and reports the result; the test is distinct from assays that only establish H. pylori infection without evaluating clarithromycin resistance.
Report 87513 for the resistance assay. Medicare pays it under the CLFS at one national amount across states and localities, with no geographic or office/facility adjustment. The 2026 national CLFS amount is $35.09, unchanged from 2025. The test is paid only through the CLFS and has no physician fee schedule payment.
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 87513
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 87513. 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 87513 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87513 on the lab fee schedule since 2025
87513 · CLFS 2026 Q4 (current)
$35.09
Unchanged since Jan 1, 2025
8 quarterly CLFS releases on file, first CLFS 2025 Q1. A code missing from a quarter wasn’t on that release.
87513 compared with similar tests
- 83013H. pylori Breath TestCarbon-13 urease analysis$67.36
- 83013 is used for H. pylori breath testing to evaluate infection. Code 87513 evaluates clarithromycin resistance.
- 87338H. pylori antigenStool immunoassay$14.38
- 87338 is an H. pylori stool antigen test for infection; 87513 is an amplified nucleic acid test for clarithromycin resistance.
- 87186Susceptibility testMicrodilution or agar dilution$8.65
- 87186 reports antimicrobial susceptibility testing, while 87513 is the specific amplified nucleic acid assay for H. pylori clarithromycin resistance.
87513 billing questions
How does 87513 differ from an H. pylori infection test?
87513 evaluates clarithromycin resistance associated with H. pylori. An infection test that does not assess resistance answers a different clinical question.
Is 87513 a quantitative test?
No. It reports H. pylori clarithromycin resistance information, not a quantified organism level.
What method does 87513 describe?
It uses an amplified probe technique for nucleic acid detection.
How does Medicare pay for 87513?
Medicare pays the test through the CLFS at one national amount across localities, without geographic 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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