CPT code 87523: Hepatitis D test, quantitative nucleic acid test2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Quantitative hepatitis D nucleic-acid testing measures viral material to evaluate or monitor infection, typically in patients with hepatitis B.
Medicare pays $42.84 for 87523 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 2024
- 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 87523 covers
Code 87523 identifies quantitative testing for hepatitis D (delta) nucleic acid, with reverse transcription when performed. Hepatitis D infection occurs in association with hepatitis B, so clinicians may order the assay when evaluating or monitoring HDV in that setting. Hepatology and infectious disease clinicians commonly manage these patients; clinical laboratories perform the testing on serum or plasma.
Report 87523 for the quantitative HDV assay, not for HBV or HCV testing. Medicare pays it only through the CLFS, at one national amount across all localities and with no office-versus-facility difference. The 2026 national CLFS amount is $42.84, unchanged from 2024. The service is excluded from the physician fee schedule.
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 87523
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 87523. 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 87523 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87523 on the lab fee schedule since 2024
87523 · CLFS 2026 Q4 (current)
$42.84
Unchanged since Jan 1, 2024
12 quarterly CLFS releases on file, first CLFS 2024 Q1. A code missing from a quarter wasn’t on that release.
87523 compared with similar tests
- 87517HBV viral loadQuantitative DNA test$42.84
- Use 87517 for quantitative hepatitis B DNA testing; use 87523 for quantitative hepatitis D nucleic-acid testing.
- 87516HBV DNA testAmplified probe detection$35.09
- 87516 reports hepatitis B DNA detection by amplification, rather than quantitative hepatitis D testing.
- 87522HCV viral loadQuantitative RNA$42.84
- 87522 is for quantitative hepatitis C RNA testing. Choose 87523 when the assay quantifies hepatitis D.
87523 billing questions
When is 87523 appropriate?
Use it for quantitative testing of hepatitis D nucleic acid. Clinicians may order it when evaluating or monitoring hepatitis D infection in a patient with hepatitis B.
How does 87523 differ from 87517?
87523 quantifies hepatitis D nucleic acid; 87517 quantifies hepatitis B DNA. Select the code for the virus measured by the assay.
Can an HBV test be reported with 87523?
An HBV nucleic-acid test may be reported alongside 87523 when both assays are performed. Code 87517 is the quantitative HBV DNA test.
What specimen is used?
The assay is performed on a blood-derived specimen, commonly serum or plasma.
How does Medicare pay 87523?
Medicare pays it through the CLFS, not the physician fee schedule. The CLFS amount is national and does not vary by locality or by office versus facility setting.
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
Fee sheets · Coming soon
Put 87523 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist