CPT code 87564: TB resistance test, rifampin, amplified probe2026 Medicare lab fee · Clinical Laboratory Fee Schedule
An amplified-probe nucleic acid test detects rifampin resistance associated with Mycobacterium tuberculosis and is reported for that resistance assay.
Medicare pays $76.77 for 87564 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
$76.77
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2025
- 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 87564 covers
87564 identifies nucleic-acid detection of rifampin resistance associated with Mycobacterium tuberculosis using an amplified probe. It is distinct from codes for detecting M. tuberculosis itself: those codes target the organism, while 87564 targets rifampin resistance. Select this code for the resistance assay performed, not for a general M. tuberculosis nucleic-acid detection or quantitative result. Report it when the rifampin-resistance test is performed; do not substitute an organism-detection code merely because the assay concerns tuberculosis.
Medicare pays 87564 through the Clinical Laboratory Fee Schedule (CLFS). The code has one national amount across states and localities, without geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $76.77, unchanged from 2025. The physician fee schedule classifies the test as excluded by statute, so Medicare pays it 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 87564
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 87564. 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 87564 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87564 on the lab fee schedule since 2025
87564 · CLFS 2026 Q4 (current)
$76.77
Unchanged since Jan 1, 2025
8 quarterly CLFS releases on file, first CLFS 2025 Q1. A code missing from a quarter wasn’t on that release.
87564 compared with similar tests
- 87556TB DNA testAmplified probe$41.68
- Use 87556 for amplified-probe detection of M. tuberculosis itself; use 87564 when the test targets rifampin resistance.
- 87557TB DNA testQuantitative molecular assay$42.84
- 87557 is quantitative M. tuberculosis nucleic-acid testing; 87564 detects rifampin resistance.
- 87551Mycobacteria DNA testAmplified probe detection$48.24
- 87551 is amplified-probe testing for mycobacteria; 87564 specifically targets rifampin resistance associated with M. tuberculosis.
87564 billing questions
When should 87564 be reported instead of 87556?
Report 87564 for amplified-probe testing of M. tuberculosis rifampin resistance. Code 87556 is for amplified-probe detection of M. tuberculosis itself.
Can 87564 be reported with an M. tuberculosis detection test?
Yes, when both tests are performed: one detects M. tuberculosis, while 87564 tests for rifampin resistance.
Is modifier 26 appropriate for 87564?
No. Medicare pays 87564 only through the CLFS; it is excluded from the physician fee schedule.
How does Medicare pay for 87564?
Medicare pays one national CLFS amount per code, without locality or office-versus-facility adjustment.
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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