CPT code 87540: Legionella DNA, direct-probe detection2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Detects Legionella pneumophila DNA by direct probe for laboratory evaluation of suspected Legionnaires’ disease, distinct from amplification and quantitative Legionella assays.
Medicare pays $20.05 for 87540 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
$20.05
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 87540 covers
This molecular microbiology service detects Legionella pneumophila DNA with a direct probe. It is distinct from assays that amplify the target and from quantitative tests. Laboratories report it when testing for this water-associated bacterium in the evaluation of suspected Legionnaires’ disease. Clinical laboratories perform the molecular assay and report its result to ordering clinicians.
Report 87540 for direct-probe DNA detection; use the corresponding Legionella code when the laboratory performs amplification-probe testing or quantitative DNA testing. Medicare pays this test only through the CLFS. The 2026 national amount is $20.05 and has remained unchanged since 2020; one national amount applies across localities, with no office or facility payment difference.
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 87540
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 87540. 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 87540 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87540 on the lab fee schedule since 2020
87540 · CLFS 2026 Q4 (current)
$20.05
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.
87540 compared with similar tests
- 87541Legionella DNAAmplified probe$35.09
- Choose 87540 for direct-probe detection; choose 87541 when the laboratory performs an amplification-probe assay for Legionella pneumophila.
- 87542Legionella DNAQuantitative assay$41.76
- 87540 reports direct-probe detection, while 87542 is used when the assay quantifies Legionella pneumophila DNA.
- 87449Other antigen testEach organism, unspecified target$11.98
- 87540 detects Legionella pneumophila DNA by direct probe. Use 87449 for infectious-agent antigen detection by immunoassay when that method is performed.
87540 billing questions
When should 87540 be chosen over 87541?
Use 87540 for direct-probe detection of Legionella pneumophila DNA. Use 87541 when the laboratory performs an amplification-probe assay.
How does 87540 differ from 87542?
87540 reports direct-probe detection; 87542 is for quantitative Legionella pneumophila DNA testing.
Does 87540 report a DNA quantity?
No. It represents direct-probe detection, not quantitative measurement of Legionella pneumophila DNA.
How does 87540 differ from 87449?
87540 identifies Legionella pneumophila DNA by direct probe. Code 87449 is for infectious-agent antigen detection by immunoassay.
How does Medicare pay for 87540?
Medicare pays it through the CLFS at one national amount, with no locality or 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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