CPT code 87633: Respiratory panel, 12–25 targets2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Multiplex nucleic acid testing for 12–25 respiratory virus targets is reported when a broad respiratory pathogen panel is performed.
Medicare pays $416.78 for 87633 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
$416.78
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
- $416.78
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 87633 covers
This assay uses multiplex nucleic acid testing to detect multiple respiratory viruses in one panel, with reverse transcription when needed. Panels may include targets for viruses such as influenza, respiratory syncytial virus, adenovirus, coronavirus, metapneumovirus, parainfluenza, and rhinovirus. A laboratory reports the code for a panel covering 12–25 targets, commonly during evaluation of acute respiratory illness when several viral causes are under consideration.
Report the panel once for the test performed, rather than billing separately for each target. CMS also lists a CLIA-waived version; modifier QW identifies that version for sites holding a CLIA certificate of waiver. Medicare pays the test only through the CLFS. The 2026 national CLFS amount is $416.78, unchanged since 2020; the amount is the same across localities, without geographic or office/facility adjustment. The test 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 87633
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 87633. 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 87633 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 87633 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $416.78.
87633 on the lab fee schedule since 2020
87633 · CLFS 2026 Q4 (current)
$416.78
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.
87633 compared with similar tests
- 87631Respiratory virus panelThree to five targets$142.63
- Use 87631 for a respiratory virus panel with 3–5 targets; 87633 is for a panel with 12–25 targets.
- 87632Respiratory panelSix to eleven targets$218.06
- Use 87632 for a panel with 6–11 targets. The 12–25 target range identifies 87633.
- 87637Respiratory testSARS-CoV-2, flu, and RSV$142.63
- 87637 is for the specific combination of SARS-CoV-2, influenza A and B, and RSV. Use 87633 for a panel covering 12–25 respiratory virus targets.
- 87634RSV testAmplified probe detection$70.20
- 87634 is directed at RSV alone, while 87633 reports a multiplex panel covering 12–25 respiratory virus targets.
87633 billing questions
How does 87633 differ from 87631 and 87632?
The distinction is the number of respiratory virus targets in the panel: 87631 covers 3–5, 87632 covers 6–11, and 87633 covers 12–25. Select the code that matches the panel performed.
Should the targets be billed as separate units?
No. Report the panel once for the test performed; do not report a separate unit for each target detected.
When is modifier QW appropriate?
Use QW for the CLIA-waived version when the testing site holds a CLIA certificate of waiver and performs that waived test.
Does Medicare pay 87633 under the physician fee schedule?
No. Medicare pays this test through the CLFS, with one national amount across localities and no office or facility adjustment.
When would 87637 be a better fit?
Use 87637 for the panel targeting SARS-CoV-2, influenza A and B, and RSV. Use 87633 when the performed panel covers 12–25 respiratory virus targets.
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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