CPT code 87800: Direct-probe test, multiple organisms2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Direct-probe nucleic-acid testing detects multiple infectious organisms and is reported when the assay uses this method rather than amplification.
Medicare pays $43.67 for 87800 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
$43.67
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 87800 covers
87800 identifies nucleic-acid testing that uses direct probes to detect more than one infectious organism. The assay may detect DNA or RNA. A clinical laboratory reports the code for this direct-probe, multi-organism test. The code is selected by both the multiple-organism scope and direct-probe method; a multiple-organism assay using nucleic-acid amplification is reported under 87801.
Medicare pays 87800 through the CLFS. The 2026 national CLFS amount is $43.67, unchanged since 2020; one amount applies in every state and locality, with no office or facility difference. The physician fee schedule excludes the test by statute. Select 87800 when the assay uses direct probes for multiple organisms, rather than amplification.
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 87800
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 87800. 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 87800 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87800 on the lab fee schedule since 2020
87800 · CLFS 2026 Q4 (current)
$43.67
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.
87800 compared with similar tests
- 87801Multiplex NAATAmplified probes$70.20
- Choose 87800 for multiple-organism direct-probe testing; choose 87801 when the multiple-organism assay uses nucleic-acid amplification.
- 87480Candida probeDirect probe$20.05
- 87480 describes direct-probe testing for Candida species. 87800 describes a direct-probe assay for multiple organisms.
- 87510Gardnerella testDirect probe technique$20.05
- 87510 describes direct-probe testing for Gardnerella vaginalis. 87800 describes a direct-probe assay for multiple organisms.
87800 billing questions
How does 87800 differ from 87801?
87800 identifies multiple-organism testing using direct probes. 87801 identifies multiple-organism testing using nucleic-acid amplification.
Does 87800 count each detected organism separately?
87800 identifies a multiple-organism direct-probe assay. Select the code based on the assay performed and its detection method.
When is 87480 used instead of 87800?
87480 describes direct-probe detection of Candida species. Use it when that is the test performed, rather than a multiple-organism direct-probe assay.
Does Medicare pay 87800 under the physician fee schedule?
No. Medicare pays this test through the CLFS; the physician fee schedule excludes it by statute.
Does Medicare payment for 87800 vary by locality or setting?
No. The national CLFS amount applies across localities, with no office or facility difference.
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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