CPT code 87556: TB DNA test, amplified probe2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This amplified-probe nucleic acid test detects Mycobacterium tuberculosis DNA and is reported for organism detection rather than quantitative measurement.
Medicare pays $41.68 for 87556 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
$41.68
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 87556 covers
87556 identifies Mycobacterium tuberculosis (M. tuberculosis), the bacterium associated with TB, through a nucleic acid test using an amplified-probe approach. It reports detection of the organism’s DNA rather than a quantitative measurement. The code distinguishes this specific organism target and method from codes for direct-probe detection, quantitative testing, or broader Mycobacteria testing. Clinical laboratories report 87556 for amplified-probe M. tuberculosis DNA detection. The code identifies organism detection, not a rifampin resistance assay.
Medicare pays 87556 through the Clinical Laboratory Fee Schedule (CLFS), at one national amount per code that applies across states and localities without geographic or office/facility adjustment. The 2026 national CLFS amount is $41.68, unchanged from 2020 through 2026. The test is excluded from the physician fee schedule and is paid only through the CLFS.
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 87556
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 87556. 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 87556 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87556 on the lab fee schedule since 2020
87556 · CLFS 2026 Q4 (current)
$41.68
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.
87556 compared with similar tests
- 87555TB DNA testDirect probe$26.88
- Both target M. tuberculosis DNA, but 87555 describes direct-probe testing and 87556 describes amplified-probe testing.
- 87557TB DNA testQuantitative molecular assay$42.84
- Use 87557 for quantitative M. tuberculosis DNA testing. Code 87556 describes amplified-probe detection rather than quantification.
- 87564TB resistance testRifampin, amplified probe$76.77
- Code 87564 addresses M. tuberculosis rifampin resistance; 87556 detects M. tuberculosis DNA.
- 87551Mycobacteria DNA testAmplified probe detection$48.24
- 87551 describes amplified-probe testing for Mycobacteria broadly, whereas 87556 specifically targets M. tuberculosis.
87556 billing questions
How does 87556 differ from 87555?
87556 describes amplified-probe detection of M. tuberculosis DNA. Code 87555 describes direct-probe detection of the same organism.
Is 87556 a quantitative TB test?
No. It reports amplified-probe detection of M. tuberculosis DNA; 87557 is for quantitative testing.
Does Medicare pay 87556 under the physician fee schedule?
No. Medicare pays this test through the CLFS at one national amount across localities and settings.
How does 87556 differ from rifampin resistance testing?
87556 detects M. tuberculosis DNA. Code 87564 addresses M. tuberculosis rifampin resistance.
When is 87551 considered instead?
87551 describes amplified-probe DNA testing for Mycobacteria more broadly, while 87556 specifies M. tuberculosis.
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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