CPT code 87810: Chlamydia test, direct visual immunoassay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A direct-visual immunoassay for Chlamydia trachomatis antigen, reported when testing a patient for suspected chlamydial infection.
Medicare pays $35.29 for 87810 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
$35.29
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 87810 covers
The assay detects Chlamydia trachomatis antigen using an immunoassay whose result is read by direct visual observation. It is an organism-specific laboratory test used in evaluating suspected chlamydial infection. A laboratory reports this code when it performs this antigen-detection method; it distinguishes this method from nucleic-acid testing and tests for other organisms. The code is specific to this target and method.
Report the code for the assay performed. Medicare pays the test under the CLFS at one national amount per code in every state and locality, without geographic or office/facility adjustment. The 2026 national CLFS amount is $35.29, unchanged since 2020. Payment is only through the CLFS; the service 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 87810
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 87810. 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 87810 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87810 on the lab fee schedule since 2020
87810 · CLFS 2026 Q4 (current)
$35.29
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.
87810 compared with similar tests
- 87850Gonorrhea assayDirect visual immunoassay$24.56
- Use 87810 for a C. trachomatis antigen assay and 87850 for a Neisseria gonorrhoeae assay; the organism tested determines the code.
- 87800Direct-probe testMultiple organisms$43.67
- 87810 identifies a direct-visual immunoassay for C. trachomatis antigen. Code 87800 identifies direct DNA detection of multiple infectious agents.
- 87801Multiplex NAATAmplified probes$70.20
- 87810 is a direct-visual antigen assay for C. trachomatis; 87801 identifies amplified DNA detection of multiple infectious agents.
87810 billing questions
What distinguishes this test from a chlamydia nucleic acid test?
This code identifies antigen detection by immunoassay with direct visual observation. Nucleic-acid tests use a different detection method and are reported with the code that matches that method.
Is this code specific to Chlamydia trachomatis?
Yes. Report it for the direct-visual immunoassay detecting C. trachomatis antigen, not for testing another organism or multiple agents.
How many units should be reported?
Report the code for the assay performed. It identifies the organism-specific direct-visual antigen test.
How does Medicare pay for this test?
Medicare pays it through the CLFS at one national amount that applies in every state and locality, without an office-versus-facility difference.
What should documentation identify?
Document that the test detects C. trachomatis antigen by immunoassay 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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