CPT code 87880: Rapid strep test, group A antigen, visual2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A direct-visual immunoassay detects group A streptococcal antigen, commonly during evaluation of sore throat or suspected streptococcal pharyngitis.
Medicare pays $16.53 for 87880 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
$16.53
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
- $16.53
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 87880 covers
This rapid antigen test detects group A Streptococcus using an immunoassay read by direct visual observation. It is commonly ordered when a patient has sore throat or suspected streptococcal pharyngitis. The usual specimen is a throat swab. Office and urgent care teams often perform the test during the visit; laboratories may also report it when they perform the same assay. The result helps identify group A strep as a cause of the patient’s symptoms.
Report this code for the group A strep visual immunoassay performed. For a CLIA-waived version performed by a site holding a CLIA certificate of waiver, report modifier QW. Medicare pays the test under the CLFS, not the physician fee schedule. The 2026 national CLFS amount is $16.53, unchanged since 2020. One amount applies in every state and locality, with no office or 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 87880
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 87880. 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 87880 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 87880 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $16.53.
87880 on the lab fee schedule since 2020
87880 · CLFS 2026 Q4 (current)
$16.53
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.
87880 compared with similar tests
- 87651Strep A testAmplified nucleic acid$35.09
- This code is for a direct-visual group A strep antigen immunoassay. Use 87651 for group A strep detection by nucleic acid amplification.
- 87081Culture screenScreening only$6.63
- This code reports the visual antigen test; 87081 reports a screening culture. Select according to the test actually performed.
- 87802Strep B assayDirect visual immunoassay$12.73
- 87802 is the direct-visual antigen assay for group B Streptococcus. This code is specific to group A Streptococcus.
87880 billing questions
When should this code be used instead of a molecular strep test?
Use it for a group A strep antigen immunoassay read by direct visual observation. A molecular nucleic acid test uses a different method and is reported with the code for that assay.
Does this code identify group B strep?
No. This code is for group A Streptococcus; group B strep has a separate assay code.
When is modifier QW appropriate?
Report QW for the CLIA-waived version when the testing site holds a CLIA certificate of waiver.
How does Medicare pay for this test?
Medicare pays it under the CLFS at one national amount, regardless of locality or office versus facility setting. It is excluded from the physician fee schedule.
Does a throat culture use this code?
No. This code is for the visual antigen test; a throat culture is a different test.
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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