CPT code 87623: Low-risk HPV, nucleic acid detection2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This nucleic acid test detects low-risk human papillomavirus types and is reported when a laboratory evaluates a specimen for low-risk HPV.
Medicare pays $35.09 for 87623 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
- 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 87623 covers
This nucleic acid test detects low-risk human papillomavirus (HPV) types. Clinicians may order it when evaluating suspected low-risk HPV infection, and the laboratory reports detection from the submitted specimen. The result is distinct from high-risk HPV testing.
Report 87623 for low-risk HPV nucleic acid detection. It does not describe high-risk HPV testing; select the code that matches the HPV types detected and how the results are reported. Medicare pays 87623 through the CLFS at one national amount in every state and locality, with no office-versus-facility payment difference. The 2026 national amount is $35.09, unchanged from 2020 through 2026. The service is paid only through the CLFS and is excluded from the physician fee schedule.
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 87623
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 87623. 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 87623 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87623 on the lab fee schedule since 2020
87623 · 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.
87623 compared with similar tests
- 87624High-risk HPVPooled result$35.09
- 87623 detects low-risk HPV types. 87624 detects high-risk types and reports a pooled result.
- 87625HPV genotypingTypes 16 and 18$40.55
- 87625 is limited to HPV types 16 and 18; 87623 is for low-risk HPV types.
- 87626HPV testSeparate types and pooled results$70.20
- 87626 reports selected high-risk HPV types separately and others as a pool; 87623 detects low-risk types.
87623 billing questions
When should 87623 be selected instead of a high-risk HPV code?
Use 87623 when the test detects low-risk HPV types. For high-risk HPV testing, select the code that matches the types detected and result reporting.
Does 87623 include high-risk HPV testing?
No. It describes detection of low-risk HPV types; high-risk HPV testing is a separate service reported with the applicable code.
How does Medicare pay for 87623?
Medicare pays it through the CLFS at one national amount across states and localities, with no office-versus-facility payment difference.
Is 87623 paid under the physician fee schedule?
No. Medicare pays this test only through the CLFS; it is excluded from the physician fee schedule.
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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