CPT code 87533: HHV-6 DNA, quantitative assay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Quantitative HHV-6 DNA testing reports the amount of viral DNA detected in a specimen when a laboratory performs this assay.
Medicare pays $41.76 for 87533 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
$41.76
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 87533 covers
This laboratory molecular test detects and quantifies HHV-6 DNA in a patient specimen. Quantitative reporting distinguishes it from HHV-6 DNA assays that detect the target without quantifying it. A clinical laboratory performs and reports the assay, providing a quantitative measure of HHV-6 DNA detected in the specimen.
Report 87533 for the quantitative HHV-6 DNA assay, rather than the direct-probe or amplification HHV-6 DNA assays represented by 87531 and 87532. Medicare pays the test only through the Clinical Laboratory Fee Schedule (CLFS). The 2026 national CLFS amount is $41.76 and has remained unchanged since 2020. The CLFS amount is the same in every state and locality, without geographic or office-versus-facility adjustment. The test has no separate 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 87533
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 87533. 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 87533 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87533 on the lab fee schedule since 2020
87533 · CLFS 2026 Q4 (current)
$41.76
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.
87533 compared with similar tests
- 87531HHV-6 DNA testDirect probe detection$58.00
- 87531 identifies direct-probe HHV-6 DNA testing. Use 87533 when the laboratory performs the quantitative HHV-6 DNA assay.
- 87532HHV-6 DNA testAmplified probe detection$35.09
- 87532 identifies HHV-6 DNA amplification. Code 87533 identifies the quantitative HHV-6 DNA assay.
- 87530HSV DNAQuantitative viral level$42.84
- 87530 quantifies herpes simplex virus DNA, not HHV-6 DNA. The target virus determines which code applies.
- 87517HBV viral loadQuantitative DNA test$42.84
- 87517 quantifies hepatitis B virus DNA. It is not an HHV-6 assay.
87533 billing questions
How does this code differ from 87532?
Code 87532 identifies an HHV-6 DNA amplification assay. Use 87533 for the quantitative HHV-6 DNA assay.
How does this code differ from 87531?
Code 87531 identifies direct-probe HHV-6 DNA testing. Use 87533 for the quantitative HHV-6 DNA assay.
What does quantitative testing report?
It reports a quantity of HHV-6 DNA detected in the specimen, rather than only identifying the target.
Is there a separate physician fee schedule payment?
No. Medicare pays this test through the CLFS, with no separate physician fee schedule payment.
Does Medicare payment vary by locality or setting?
No. The CLFS amount is national and applies across localities, without an office-versus-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
Fee sheets · Coming soon
Put 87533 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist