CPT code 87850: Gonorrhea assay, direct visual immunoassay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports visual immunoassay detection of Neisseria gonorrhoeae antigen when that specific laboratory method is performed for gonorrhea testing.
Medicare pays $24.56 for 87850 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
$24.56
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 87850 covers
This laboratory assay detects Neisseria gonorrhoeae antigen by immunoassay, with the result read through direct visual observation. It identifies a gonorrhea antigen test, not a nucleic acid amplification method or a multiple-agent assay. Report 87850 when that is the method and target performed; use a different code when the laboratory performs another method or tests another organism.
Medicare pays 87850 under the CLFS at one nationally priced amount that applies across states and localities, without geographic adjustment or an office-versus-facility difference. The 2026 national CLFS amount is $24.56, unchanged from 2020 through 2026. The test is paid only from the CLFS, rather than the physician fee schedule. The code represents this specific organism-and-method combination, so report the code matching the test performed.
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 87850
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 87850. 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 87850 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87850 on the lab fee schedule since 2020
87850 · CLFS 2026 Q4 (current)
$24.56
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.
87850 compared with similar tests
- 87591Gonorrhea testAmplified DNA probe$35.09
- Both address gonorrhea, but 87591 represents nucleic acid amplification. Use 87850 for antigen detection by immunoassay with direct visual observation.
- 87810Chlamydia testDirect visual immunoassay$35.29
- Both are direct-visual immunoassays, but 87810 detects Chlamydia trachomatis; 87850 detects Neisseria gonorrhoeae.
- 87801Multiplex NAATAmplified probes$70.20
- 87801 is for a multiple-agent nucleic acid amplification assay. Use 87850 for direct-visual immunoassay detection of gonorrhea antigen.
87850 billing questions
When is 87850 appropriate instead of a gonorrhea NAAT?
Use 87850 when the performed test detects gonorrhea antigen by immunoassay with a direct visual read. A nucleic acid amplification test is reported with the code for that method, such as 87591.
Should 87850 be reported with a chlamydia assay?
A separate chlamydia assay may be reported when that organism is also tested. Code 87810 is the direct-visual immunoassay code for Chlamydia trachomatis.
What should the documentation identify?
Document the gonorrhea test performed and support that it detects antigen by direct visual immunoassay.
How does Medicare pay 87850?
Medicare pays 87850 under the CLFS using one national amount across localities, without an office-versus-facility payment difference. The test is paid only from 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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