CPT code 87557: TB DNA test, quantitative molecular assay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Quantitative nucleic acid testing detects Mycobacterium tuberculosis DNA and is reported for assays that measure the amount of this specific target.
Medicare pays $42.84 for 87557 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 87557 covers
87557 identifies nucleic-acid testing that quantifies Mycobacterium tuberculosis DNA. The result measures the amount of this specific target. Codes 87555 and 87556 identify direct-probe and amplification-detection approaches, respectively; 87557 identifies quantification. It is specific to M. tuberculosis, unlike quantitative mycobacteria DNA testing under 87552. Laboratories report this code for the quantitative M. tuberculosis assay.
Medicare pays 87557 through the CLFS only; the service is excluded from the physician fee schedule by statute. The CLFS uses one national amount in every state and locality, with no geographic adjustment or office/facility difference. The 2026 national amount is $42.84, unchanged from 2020 through 2025.
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 87557
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 87557. 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 87557 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87557 on the lab fee schedule since 2020
87557 · 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.
87557 compared with similar tests
- 87555TB DNA testDirect probe$26.88
- 87555 identifies a direct-probe approach for M. tuberculosis DNA. Choose 87557 when the assay quantifies the target.
- 87556TB DNA testAmplified probe$41.68
- 87556 identifies amplification-based detection of M. tuberculosis DNA; 87557 identifies the quantitative assay.
- 87552Mycobacteria quantificationQuantitative nucleic-acid assay$42.84
- 87552 identifies quantitative mycobacteria DNA testing without the M. tuberculosis-specific target of 87557.
- 87564TB resistance testRifampin, amplified probe$76.77
- 87564 identifies M. tuberculosis rifampin-resistance testing; 87557 quantifies M. tuberculosis DNA.
87557 billing questions
When should 87557 be selected instead of 87555 or 87556?
Use 87557 when the M. tuberculosis DNA assay quantifies the target. Codes 87555 and 87556 identify direct-probe and amplification-detection approaches, respectively.
Is 87557 a general mycobacteria test?
No. It identifies quantitative testing for M. tuberculosis DNA. Code 87552 identifies quantitative mycobacteria DNA testing without that same specific target.
How does Medicare pay 87557?
Medicare pays the test through the CLFS only. The CLFS amount is national, and the service is excluded from the physician fee schedule.
How does 87557 differ from 87564?
87557 quantifies M. tuberculosis DNA. Code 87564 identifies testing for M. tuberculosis rifampin resistance.
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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