CPT code 89055: Stool leukocytes, stool white-cell estimate2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This laboratory test evaluates white blood cells in stool and is reported when clinicians assess diarrhea for possible intestinal inflammation.
Medicare pays $4.27 for 89055 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
$4.27
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 89055 covers
Clinical laboratories evaluate white blood cells in a stool specimen by noting their presence or estimating their amount. Clinicians may order the test when evaluating diarrhea and possible intestinal inflammation. It is used in outpatient care, and the result contributes to the clinical assessment without identifying a specific organism.
Report 89055 for the stool leukocyte assessment. Choose a body-fluid cell-count code when the specimen is a nonfecal fluid. Medicare pays 89055 through the CLFS at one national amount, with no locality, geographic, or office-versus-facility adjustment. The 2026 national CLFS amount is $4.27, unchanged from 2020 through 2026. The test is paid only under the CLFS.
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 89055
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 89055. 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 89055 with status X (excluded by statute), so the test itself is paid only from the CLFS.
89055 on the lab fee schedule since 2020
89055 · CLFS 2026 Q4 (current)
$4.27
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.
89055 compared with similar tests
- 89050Fluid cell countWithout differential$4.72
- 89055 assesses white blood cells in stool. 89050 is for a cell count on a nonfecal body-fluid specimen.
- 89051Body fluid countWith cell identification$5.60
- 89051 reports a body-fluid cell count with differential; 89055 assesses white blood cells in stool.
- 87045Stool cultureAerobic, Salmonella and Shigella$9.44
- 87045 is a bacterial stool culture, not a leukocyte assessment. It may be performed as a separate test in the same diarrhea workup.
89055 billing questions
When should 89055 be chosen over a body-fluid cell-count code?
Use 89055 to assess white blood cells in stool. Codes 89050 and 89051 describe cell counts on other body fluids.
Does 89055 identify the cause of diarrhea?
No. It evaluates white blood cells in stool; it does not identify a specific infectious organism.
Can a stool culture be reported for the same workup?
A stool culture, such as 87045, may be ordered alongside 89055 when the clinician is evaluating diarrhea for a bacterial cause. Each represents a different laboratory service.
How does Medicare pay for 89055?
Medicare pays 89055 through the CLFS at one national amount, with no locality or office-versus-facility adjustment. The test is paid only under the CLFS.
How does 89051 differ from 89055?
89051 is for a body-fluid cell count with differential. 89055 assesses white blood cells in a stool specimen.
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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