CPT 87880: rapid strep antigen test
CPT 87880 reports a rapid antigen test for group A strep that is read by direct visual observation, the quick swab-and-strip strep test. Medicare pays it under the clinical laboratory fee schedule, not the physician fee schedule, and the CMS lab file carries a QW row for it.
Written by Salman Saeed, CEO and Co-Founder · Reviewed by a Certified Medical Coder · Last reviewed October 2026In short: 87880 is status X in the October 2026 RVU file, meaning it is paid under the lab fee schedule. The Q4 2026 lab file lists it with and without modifier QW at 16.53, the MUE is 2, and the CLIA number goes in box 23 of the CMS-1500.
What does CPT 87880 report?
87880 is a CPT code for a rapid immunoassay that detects group A streptococcus antigen with a direct visual read. In plain words it is the quick strep strip, not a culture and not an instrument-read molecular test.
| Item | Value in the CMS files |
|---|---|
| Short label CMS uses | Strep a assay w/optic |
| Physician fee schedule status (RVU26D, October 2026) | X, with no RVUs |
| Clinical lab fee schedule rate (CY 2026 Q4 file) | 16.53, listed with and without modifier QW |
| NCCI MUE (Q4 2026 practitioner table) | 2, indicator 3, clinical data |
RVU26D defines status X as a statutory exclusion: the item is not in the statutory definition of physician services, no RVUs or payment are shown, and no payment is made under the physician fee schedule. Clinical diagnostic laboratory services are the example CMS gives.
Does 87880 need modifier QW?
Check the QW row. In the CY 2026 Q4 lab fee schedule file, 87880 appears both without a modifier and with QW, and the file's layout says that where a modifier is shown, QW denotes a CLIA waived test.
Chapter 16 of the Claims Processing Manual, section 70.8, says CMS gives the MACs an updated list of waived tests quarterly, and that to be recognized as waived some codes carry unique HCPCS codes and some must have QW. The sites that bill a waived test must hold a certificate of waiver or one of the higher certificate types.
- QW on a line says the test was run with a CLIA waived system.
- A waived certificate fits waived tests. Section 70.9 says a claim for a test on the CLIA-edit list needs a registration, compliance or accreditation certificate.
- A different method gets a different code. CMS's MM12841 article lists 87651QW for the Accula Strep A Test, and the lab file prices 87651 at 35.09.
How is 87880 paid?
Medicare pays it from the clinical laboratory fee schedule at the rate in the quarterly file: 16.53 in the CY 2026 Q4 release. The visit, if any, is paid separately under the physician fee schedule.
Chapter 16 section 30.2 says neither the Part B deductible nor the 20 percent coinsurance applies to clinical laboratory tests performed by a physician, laboratory or other entity paid on an assigned basis. See laboratory billing for how labs handle the fee schedule.
The MUE of 2 means a claim for one date of service is stopped above two units. In the file, indicator 3 reads "Date of Service Edit: Clinical", so the cap applies to one date of service and rests on clinical data. A second unit needs a note that explains it.
How does 87880 sit on the CMS-1500?
87880 goes in box 24D of the CMS-1500 with QW added when the test was waived, and the CLIA number goes in box 23. Chapter 16 section 70.10 says the number belongs on the 837P in REF02 with qualifier X4, or in box 23 on paper.
- Enter the visit, for example 99213, on its own line.
- Enter 87880 with QW on a second line, units 1, with a diagnosis pointer in box 24E.
- Put the CLIA number of the site that ran the test in box 23.
- If more than one site ran tests, bill each CLIA number on a separate claim as section 70.10 describes.
How do the strep test, QW and CLIA appear on the claim?
A rapid strep test is 87880 in Item 24D with QW for a waived kit and 1 unit in Item 24G. Chapter 26 says the 10-digit CLIA number goes in Item 23. Item 24E points to the throat symptom, such as sore throat or fever.
RVU26D gives 87880 status X, so there are no RVUs or payment amounts under the physician fee schedule. The MUE table allows 2 per date with indicator 3.
Example: A student with a sore throat is tested on 10/14. The line is 87880 QW, pointer A (J02.9), 1 unit, $18.00. If the CLIA number is for a different site than the one that did the test, the payer may return the claim under CO-16.
Why is 87880 denied?
Medicare lab denials come from the CLIA edit more often than from the code. These are the pairs CMS and X12 define.
| Code | What it says | Cause |
|---|---|---|
| CARC 16 with RARC MA120 | Claim lacks information or has a billing error; MA120 is a missing, incomplete or invalid CLIA certification number | No CLIA number on the claim, per section 70.10.1 |
| CO B7 | This provider was not certified or eligible to be paid for this procedure on this date of service | Office lab out of compliance, section 70.11 |
| CARC 97 | The benefit is included in the payment for another service already adjudicated | A payer that bundles the test into the visit |
If these denials keep coming back, our denial management team can work them. See CO-16, the sibling flu test 87804 and the urgent care billing page.
Related codes
- Physician Fee Schedule relative value files, RVU26D (October 2026) · CMS
- Clinical Laboratory Fee Schedule public use file, CY 2026 Q4 (October 2026) · CMS
- Medicare NCCI Medically Unlikely Edits, practitioner services table, effective 10-01-2026 · CMS
- Medicare Claims Processing Manual, Chapter 16: Laboratory Services · CMS
- New Waived Tests (MLN Matters MM12841) · CMS
- Claim Adjustment Reason Codes · X12
- Remittance Advice Remark Codes · X12
- Medicare Claims Processing Manual, Chapter 26: Completing and Processing Form CMS-1500 Data Set · CMS
We check every rule, code and deadline against the official source. See our editorial policy.
Common questions
Straight answers from the team that does the work.
Ask a billing lead directly. A 20-minute call, Monday to Friday, 9am to 5pm Eastern.
01Does a rapid strep test need modifier QW?
The CY 2026 Q4 lab fee schedule file lists 87880 with QW, where QW denotes a CLIA waived test. Use it when the test was run on a CLIA waived system, because CMS says some waived tests must carry QW to be recognized as waived.
02Is 87880 paid on the physician fee schedule?
No. The October 2026 RVU26D file gives it status X, a statutory exclusion, with no RVUs. Medicare pays it under the clinical laboratory fee schedule, which lists 16.53 for the code in the CY 2026 Q4 release, with and without QW.
03Where does the CLIA number go on the claim?
On the electronic 837P it goes in the REF segment, REF02, with qualifier X4 in REF01. On paper it goes in box 23 of the CMS-1500. Chapter 16 section 70.10 says Medicare returns laboratory claims without the number as unprocessable, and CARC 16 with RARC MA120 follows.
04How many units of 87880 can be billed?
The Q4 2026 Medicare practitioner MUE table gives 87880 a value of 2 with adjudication indicator 3, a date of service edit based on clinical data. One swab and one result is one unit, so a second unit needs support in the note.
05What if our CLIA certificate is for waived tests only?
A waived certificate fits waived tests. Chapter 16 section 70.9 says a claim for a test on the CLIA-edit list needs a registration, compliance or accreditation certificate, and the MLN notices say CMS edits laboratory claims at the certificate level, so a mismatch is denied.
Strep tests denied for CLIA or QW?
We check the certificate, the modifier and the CLIA number before the claim goes out.