CPT code 87802: Strep B assay, direct visual immunoassay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A direct-visual immunoassay for group B streptococcus antigen, reported when the performed test uses this organism target and detection method.
Medicare pays $12.73 for 87802 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
$12.73
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 7 sections
What 87802 covers
This test detects group B streptococcus antigen by immunoassay, with direct visual observation of the result. Code selection turns on both the organism target and the method performed. It describes antigen detection, not a culture or nucleic acid amplification test. The visually read group A streptococcus antigen assay is reported with 87880 because it targets a different streptococcal group.
Medicare pays the assay under the Clinical Laboratory Fee Schedule (CLFS), not the physician fee schedule; it is excluded from the physician fee schedule by statute. The 2026 national CLFS amount is $12.73, unchanged since 2020. One amount per code applies in every state and locality, with no geographic adjustment or office-versus-facility payment difference.
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 87802
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 87802. 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 87802 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87802 on the lab fee schedule since 2020
87802 · CLFS 2026 Q4 (current)
$12.73
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.
87802 compared with similar tests
- 87880Rapid strep testGroup A antigen, visual$16.53
- Both are visually read antigen immunoassays, but 87802 targets group B streptococcus and 87880 targets group A streptococcus.
- 87899Antigen assayDirect visual observation$16.07
- 87802 identifies a specific organism target: group B streptococcus. Code 87899 is for an infectious-agent assay not otherwise specified.
- 87801Multiplex NAATAmplified probes$70.20
- 87802 describes a visually read antigen immunoassay for group B streptococcus. Code 87801 describes detection of multiple agents using DNA amplification.
87802 billing questions
How is 87802 different from 87880?
87802 identifies a visually read antigen immunoassay for group B streptococcus. Code 87880 targets group A streptococcus.
Can 87802 be reported for a culture?
No. It describes antigen detection by immunoassay with direct visual observation, not culture.
Does 87802 describe a molecular test?
No. The code describes direct-visual immunoassay detection, not nucleic acid amplification.
How does Medicare pay for 87802?
Medicare pays it through the CLFS. It is excluded from the physician fee schedule by statute and has one national amount across localities and settings.
What supports selecting 87802?
The performed assay must target group B streptococcus and use immunoassay detection with direct visual observation.
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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