CPT code 87801: Multiplex NAAT, amplified probes2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports amplified-probe nucleic acid testing that detects multiple infectious organisms, distinguishing it from direct-probe and single-organism assays.
Medicare pays $70.20 for 87801 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
$70.20
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
- $70.20
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 87801 covers
This laboratory service detects DNA or RNA from multiple infectious organisms using an amplified-probe method. It differs from multiple-organism direct-probe testing and from nucleic acid assays limited to one organism. In 2024, Medicare recorded 707,824 office services and 160 facility services for this code.
For Medicare, report 87801 for the multiple-organism amplified assay. CMS lists modifier QW for the CLIA-waived version, which sites holding a CLIA certificate of waiver may perform. Medicare pays through the CLFS at a single national amount: $70.20 in 2026, unchanged since 2020. The amount is the same across states and localities, with no geographic or office/facility adjustment. The test is paid only through the CLFS, not 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 87801
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 87801. 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 87801 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 87801 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $70.20.
87801 on the lab fee schedule since 2020
87801 · CLFS 2026 Q4 (current)
$70.20
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.
87801 compared with similar tests
- 87800Direct-probe testMultiple organisms$43.67
- Both describe nucleic acid detection for multiple organisms. Choose 87801 for amplified probes and 87800 for direct probes.
- 87631Respiratory virus panelThree to five targets$142.63
- 87631 is specifically for respiratory-virus testing with three to five targets. 87801 describes multiple-organism detection by amplified probes without that respiratory-virus-specific definition.
- 87491Chlamydia testAmplified nucleic acid detection$35.09
- 87491 is for a Chlamydia trachomatis nucleic acid assay. 87801 applies when the assay detects multiple organisms.
87801 billing questions
How does 87801 differ from 87800?
87801 is for a multiple-organism assay using amplified probes. 87800 describes multiple-organism detection using a direct-probe method.
When should a single-organism code be used instead?
Use a code for a single-organism assay when the test detects one specified pathogen rather than multiple organisms. The assay performed and its targets should support the code selected.
When is modifier QW appropriate?
CMS lists a CLIA-waived version with QW. Use it when the waived test is performed by a site holding a CLIA certificate of waiver.
What documentation supports reporting 87801?
Documentation should support that the assay detects multiple organisms using amplified probes.
How does Medicare pay for 87801?
Medicare pays it under the CLFS at one national amount, without locality or office/facility differences. It is paid only through the CLFS.
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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