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87390 Hiv-1 ag ia

What 87390 is

CMS fee schedule short descriptor: Hiv-1 ag ia.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 87390 (CY2026)

This code has no Physician Fee Schedule rate: Statutory exclusion - not payable under the Physician Fee Schedule. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps 87390 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 87390? These codes are bundled into it

87390 is a Column 1 code in 4 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
87535Hiv-1 probe&reverse trnscrpj1 - modifier may bypassCheck pair
88346Imfluor 1st 1antb stain px1 - modifier may bypassCheck pair
88350Imfluor ea addl 1antb stn px1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

87390 is bundled into these codes

87390 appears as a Column 2 code in 6 active edits. Reported with one of these Column 1 codes on the same date of service, 87390 is the code that denies.

Column 1 codeShort descriptionModifier indicator
87147Culture type immunologic1Check pair
87253Virus inoculate tissue addl1Check pair
87389Hiv-1 ag w/hiv-1&-2 ab ag ia1Check pair
87536Hiv-1 quant&revrse trnscrpj0Check pair
87806Hiv ag w/hiv1&2 antb w/optic1Check pair
G0475Hiv combination assay1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.