CPT code 87591: Gonorrhea test, amplified DNA probe2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports an amplified nucleic acid test that detects Neisseria gonorrhoeae, commonly ordered during evaluation or screening for gonorrhea.
Medicare pays $35.09 for 87591 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
$35.09
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
- QW · CLIA-waived test
- $35.09
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 87591 covers
This laboratory test detects Neisseria gonorrhoeae genetic material using an amplified probe method. Clinicians may order it when evaluating possible gonorrhea or screening for infection; clinical laboratories perform and report the organism-specific result. Urine or swab specimens may be used according to the assay and collection site.
Report 87591 for amplified gonorrhea detection; when a separate Chlamydia trachomatis assay is performed, report its applicable code separately. CMS lists a CLIA-waived version, reported with modifier QW by sites holding a CLIA certificate of waiver. Medicare pays this test through the CLFS at one national amount across states and localities, with no geographic adjustment or office/facility difference. The 2026 national CLFS amount is $35.09, unchanged since 2020. The test has no separate physician-fee-schedule payment.
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 87591
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 87591. 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 87591 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 87591 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $35.09.
87591 on the lab fee schedule since 2020
87591 · CLFS 2026 Q4 (current)
$35.09
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.
87591 compared with similar tests
- 87590Gonorrhea testDirect nucleic acid probe$26.88
- 87591 is for an amplified nucleic acid method; 87590 is for direct-probe detection of gonorrhea.
- 87592Gonorrhea testQuantitative nucleic acid$42.84
- 87591 reports amplified gonorrhea detection, while 87592 represents quantitative testing.
- 87491Chlamydia testAmplified nucleic acid detection$35.09
- 87491 detects Chlamydia trachomatis. Use 87591 for gonorrhea; report both when separate tests for both organisms are performed.
87591 billing questions
When should 87591 be reported instead of 87590?
Use 87591 for an amplified gonorrhea nucleic acid test. Code 87590 identifies a direct-probe method rather than an amplification method.
How does 87591 differ from 87592?
87591 reports amplified detection of gonorrhea. Code 87592 is for quantitative gonorrhea testing, rather than the amplified detection service represented by 87591.
Can 87591 be reported with a chlamydia test?
Yes. When a separate Chlamydia trachomatis assay is performed, report its applicable code, such as 87491, in addition to 87591.
When is modifier QW appropriate?
CMS lists a CLIA-waived version of this test. Use QW when the waived version is performed at a site holding a CLIA certificate of waiver.
Does Medicare pay 87591 under the physician fee schedule?
No. Medicare pays this laboratory test through the CLFS; it has no separate physician-fee-schedule payment.
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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