CPT code 87625: HPV genotyping, types 16 and 182026 Medicare lab fee · Clinical Laboratory Fee Schedule
Nucleic acid testing identifies HPV types 16 and 18, typically supporting type-specific risk assessment after a positive high-risk HPV screening result.
Medicare pays $40.55 for 87625 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
$40.55
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 87625 covers
This nucleic acid assay detects human papillomavirus (HPV) types 16 and 18; type 45 is included when performed. It is used for type-specific HPV assessment, often as follow-up to a positive high-risk HPV screening result. Cervical specimens are commonly tested, and the ordering clinician interprets the results with the patient's screening history and, when available, cytology. Clinical laboratories perform and report the test for clinicians in outpatient and facility settings.
Report 87625 for the assay detecting these specified types. Medicare pays for it under the CLFS at one national amount across states and localities, without an office-versus-facility rate difference. The 2026 national CLFS amount is $40.55, unchanged from 2020 through 2026. The test is paid only from 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 87625
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 87625. 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 87625 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87625 on the lab fee schedule since 2020
87625 · CLFS 2026 Q4 (current)
$40.55
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.
87625 compared with similar tests
- 87624High-risk HPVPooled result$35.09
- Choose 87625 when the assay identifies HPV types 16 and 18. Code 87624 represents a pooled high-risk HPV result.
- 87626HPV testSeparate types and pooled results$70.20
- Code 87626 represents a high-risk HPV assay with separate type identification and a pooled result; 87625 is specific to types 16 and 18.
- 87623Low-risk HPVNucleic acid detection$35.09
- Code 87623 is for low-risk HPV types. Code 87625 detects the high-risk types 16 and 18.
87625 billing questions
When is this code appropriate instead of a pooled high-risk HPV test?
Use this code when the assay identifies HPV types 16 and 18. A pooled high-risk HPV assay reports a pooled result rather than this type-specific result.
Does this code identify HPV type 45?
Type 45 is included when performed. The test is reported as an assay for the specified HPV types.
What specimen is typically tested?
A cervical specimen is commonly used for HPV genotyping in screening follow-up and risk assessment.
How does Medicare pay for this test?
Medicare pays for the test through the CLFS at one national amount across localities, with no office-versus-facility rate difference.
Can this test be reported with cervical cytology?
HPV genotyping and cervical cytology may be performed together during screening or follow-up. Report each service performed under its applicable code.
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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