CPT code 87562: MAC DNA test, quantitative nucleic acid2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Quantitative nucleic acid testing for Mycobacterium avium-intracellulare is reported when the assay measures this organism's nucleic acid.
Medicare pays $42.84 for 87562 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 87562 covers
This laboratory test detects and quantifies nucleic acid from Mycobacterium avium-intracellulare. The quantitative target distinguishes it from the direct-probe MAC test (87560) and amplification-probe MAC test (87561). Select the code according to the organism and test performed: this code is for quantitative testing of M. avium-intracellulare, not the related mycobacteria or tuberculosis targets.
Medicare pays 87562 only through the CLFS, using one nationally set amount per code that applies across states, localities, and settings. The 2026 national CLFS amount is $42.84, unchanged from 2020 through 2026. There is no geographic adjustment or office-versus-facility difference in the CLFS amount. No separate physician fee schedule payment is made for this test.
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 87562
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 87562. 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 87562 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87562 on the lab fee schedule since 2020
87562 · 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.
87562 compared with similar tests
- 87560MAC probeDirect probe method$27.29
- 87560 is for direct-probe testing of Mycobacterium avium-intracellulare. Choose 87562 for quantitative testing.
- 87561MAC DNA testAmplified probe detection$35.09
- 87561 represents amplification-probe testing for Mycobacterium avium-intracellulare. This code represents quantitative testing.
- 87552Mycobacteria quantificationQuantitative nucleic-acid assay$42.84
- 87552 is a quantitative mycobacteria test with a broader target description. Use 87562 when the test targets Mycobacterium avium-intracellulare.
- 87557TB DNA testQuantitative molecular assay$42.84
- 87557 quantifies Mycobacterium tuberculosis nucleic acid. This code is for quantitative testing targeting Mycobacterium avium-intracellulare.
87562 billing questions
How does 87562 differ from 87560?
87560 is for direct-probe testing of MAC nucleic acid. Use 87562 for quantitative testing.
How does 87562 differ from 87561?
87561 is for amplification-probe testing of MAC nucleic acid. Use 87562 when the test is quantitative.
When is 87552 used instead?
87552 is a quantitative mycobacteria nucleic acid test with a broader target description. 87562 identifies quantitative testing for Mycobacterium avium-intracellulare.
Does Medicare make a separate physician fee schedule payment?
No. Medicare pays this test through the CLFS only.
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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