CPT code 87517: HBV viral load, quantitative DNA test2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Quantifies hepatitis B virus DNA in a patient specimen to assess viral replication, commonly during evaluation or monitoring of chronic hepatitis B.
Medicare pays $42.84 for 87517 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
$42.84
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 87517 covers
This molecular laboratory test quantifies hepatitis B virus (HBV) DNA, producing a viral-load result rather than simply reporting whether viral DNA was detected. It is commonly performed on serum or plasma. Hepatologists, infectious disease physicians, and primary care providers may order it to assess viral replication or monitor a patient with chronic hepatitis B, including during antiviral treatment. A clinical laboratory performs the assay and reports the quantitative result to the ordering clinician.
Report 87517 for quantitative HBV DNA testing; it differs from HBV DNA detection without quantification. Medicare pays it through the Clinical Laboratory Fee Schedule (CLFS), not the physician fee schedule. The 2026 national CLFS amount is $42.84, unchanged from 2020 through 2026. One amount applies nationwide, with no 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 87517
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 87517. 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 87517 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87517 on the lab fee schedule since 2020
87517 · CLFS 2026 Q4 (current)
$42.84
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.
87517 compared with similar tests
- 87516HBV DNA testAmplified probe detection$35.09
- Use 87517 when the HBV DNA result is quantitative. Use 87516 for HBV DNA detection without quantification.
- 87522HCV viral loadQuantitative RNA$42.84
- 87522 reports a quantitative nucleic-acid test for hepatitis C virus, not hepatitis B virus.
- 87523Hepatitis D testQuantitative nucleic acid test$42.84
- 87523 quantifies hepatitis D virus. Choose 87517 for quantitative hepatitis B virus DNA testing.
87517 billing questions
How does 87517 differ from 87516?
87517 reports quantitative HBV DNA, or viral load. Use 87516 for HBV DNA detection without a quantitative result.
Is 87517 reported for each specimen?
Report the quantitative HBV DNA assay performed. The code represents the test, not the concentration or number of DNA copies in the result.
Can modifier 26 be reported?
No. Medicare pays 87517 through the CLFS, not the physician fee schedule.
Is 87517 a hepatitis B antibody test?
No. It measures HBV DNA. Codes such as 86704 and 86706 report hepatitis B antibody testing.
How does Medicare price 87517?
Medicare pays one national CLFS amount across states and localities, with no office-versus-facility payment difference.
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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