CPT code 87530: HSV DNA, quantitative viral level2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A clinical laboratory reports 87530 for nucleic-acid testing that quantifies HSV DNA, distinguishing it from HSV direct-probe or amplification detection.
Medicare pays $42.84 for 87530 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 87530 covers
Code 87530 identifies molecular testing that detects and quantifies herpes simplex virus (HSV) DNA. Unlike HSV DNA detection codes that describe direct-probe or amplification methods, this code is for a quantitative result. The clinical laboratory performs and reports the test.
Report 87530 for quantitative HSV DNA testing; 87528 identifies direct-probe HSV DNA detection, while 87529 identifies HSV DNA detection by amplification. Medicare pays 87530 only under the CLFS, with one national amount applicable in every state and locality and no office or facility payment difference. The 2026 national CLFS amount is $42.84, unchanged since 2020. The code is excluded from the physician fee schedule by statute.
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 87530
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 87530. 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 87530 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87530 on the lab fee schedule since 2020
87530 · 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.
87530 compared with similar tests
- 87528HSV DNA testDirect probe$20.05
- 87528 is for HSV DNA detection by direct probe. Use 87530 when the test quantifies HSV DNA.
- 87529HSV DNA testAmplified probe$35.09
- 87529 represents HSV DNA detection by amplification; 87530 represents quantitative HSV DNA testing.
- 87533HHV-6 DNAQuantitative assay$41.76
- 87533 quantifies HHV-6 DNA, not HSV DNA. Choose based on the virus tested.
87530 billing questions
When should 87530 be selected instead of a qualitative HSV test?
Use 87530 when the laboratory performs quantitative HSV DNA testing and reports a measured viral level. HSV DNA detection without quantification is represented by other codes.
How does 87530 differ from 87529?
87530 is for quantitative HSV DNA testing. 87529 is for HSV DNA detection by amplification.
How does 87530 differ from 87528?
87528 is for HSV DNA detection by direct probe. 87530 is for quantitative HSV DNA testing.
Does Medicare pay 87530 under the physician fee schedule?
No. Medicare pays this test through the CLFS, with one national amount across localities and no office or 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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