CPT code 87555: TB DNA test, direct probe2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports direct-probe nucleic-acid detection of Mycobacterium tuberculosis, distinguishing this organism-specific test from broad mycobacteria, amplified-probe, and quantitative assays.
Medicare pays $26.88 for 87555 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
$26.88
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 87555 covers
This assay detects Mycobacterium tuberculosis nucleic acid using a direct-probe method. It reports organism-specific detection, distinguishing the MTB target from a broader mycobacteria target, an amplified-probe method, or a quantitative test. A clinical laboratory performs and reports the organism-specific result. Report 87555 when the assay performed is the direct-probe MTB test; code selection follows the target organism and assay method.
Medicare pays this test only through the Clinical Laboratory Fee Schedule (CLFS). The 2026 national CLFS amount is $26.88 and has remained unchanged from 2020 through 2026. The CLFS amount is the same across states and localities, with no geographic or office-versus-facility adjustment. The test 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 87555
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 87555. 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 87555 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87555 on the lab fee schedule since 2020
87555 · CLFS 2026 Q4 (current)
$26.88
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.
87555 compared with similar tests
- 87556TB DNA testAmplified probe$41.68
- Both target MTB, but 87556 represents an amplified-probe method; 87555 is for direct-probe detection.
- 87557TB DNA testQuantitative molecular assay$42.84
- 87557 is for quantitative MTB nucleic-acid testing. Use 87555 for direct-probe detection without a quantitative result.
- 87550Mycobacteria testDirect probe$20.05
- 87550 is a direct-probe mycobacteria test without the MTB-specific target. Use 87555 when the assay specifically detects M. tuberculosis.
- 87560MAC probeDirect probe method$27.29
- 87560 targets Mycobacterium avium-intracellulare, whereas 87555 targets M. tuberculosis.
87555 billing questions
How does this differ from the MTB amplified-probe code?
This code represents direct-probe detection of MTB nucleic acid. Use the amplified-probe code when the assay uses amplification.
When should the quantitative MTB code be used instead?
Use the quantitative code when the assay measures MTB nucleic acid quantity. This code represents direct-probe detection, not quantification.
Is this code specific to tuberculosis bacteria?
Yes. It identifies detection of Mycobacterium tuberculosis; a general mycobacteria assay or a test for another mycobacterial species is distinct.
How does Medicare pay for this test?
Medicare pays it only through the CLFS, at one nationally set amount across localities and settings.
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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