CPT code 87529: HSV DNA test, amplified probe2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Amplified-probe HSV DNA testing detects herpes simplex virus in a specimen when clinicians evaluate suspected active infection, including mucocutaneous or central nervous system disease.
Medicare pays $35.09 for 87529 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 87529 covers
This molecular test detects herpes simplex virus DNA using an amplified-probe method. Clinicians may order it to evaluate suspected active HSV infection, including mucocutaneous disease or possible central nervous system infection. Lesion swabs and cerebrospinal fluid are common specimen contexts. Testing is performed and reported by a clinical laboratory.
Report this code for the HSV amplified-probe detection assay, not for a viral-load measurement. The code represents the test rather than a number of viral copies. Medicare pays it under the CLFS at one national amount; the 2026 national CLFS amount is $35.09, unchanged since 2020. Payment is the same across localities, with no office or facility difference. The test is paid only from the CLFS, not 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 87529
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 87529. 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 87529 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87529 on the lab fee schedule since 2020
87529 · 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.
87529 compared with similar tests
- 87528HSV DNA testDirect probe$20.05
- Both detect HSV DNA, but 87528 is for a direct-probe method; this code is for an amplified-probe method.
- 87530HSV DNAQuantitative viral level$42.84
- 87530 measures HSV DNA quantitatively. This code reports amplified-probe detection rather than viral quantity.
- 87255HSV isolationCulture with identification$33.86
- 87255 represents viral culture. This code is for amplified-probe HSV DNA detection.
87529 billing questions
When is this code appropriate?
Use it for an amplified-probe test that detects HSV DNA in a submitted specimen, such as during evaluation of a suspected active HSV infection. It is a detection test, not a quantitative viral-load assay.
How does it differ from 87528?
Both test for HSV DNA, but 87528 describes a direct-probe method. This code is for the amplified-probe method.
How does it differ from 87530?
87530 is the quantitative HSV DNA test. Use this code for amplified-probe detection rather than measurement of viral quantity.
Does Medicare pay this through the physician fee schedule?
No. Medicare pays the test through the CLFS at one national amount, without locality or office-versus-facility payment differences.
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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