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87400 Influenza a/b each ag ia

What 87400 is

CMS fee schedule short descriptor: Influenza a/b each 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 87400 (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 87400 at 2 units 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 87400? These codes are bundled into it

87400 is a Column 1 code in 5 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
87206Smear fluorescent/acid stai1 - modifier may bypassCheck pair
87804Influenza assay w/optic0 - no modifier 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

87400 is bundled into these codes

87400 appears as a Column 2 code in 13 active edits. Reported with one of these Column 1 codes on the same date of service, 87400 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0115U0Check pair
0202U0Check pair
0225U0Check pair
0528U1Check pair
87275Influenza b ag if1Check pair
87276Influenza a ag if0Check pair
87428Sarscov & inf vir a&b ag ia0Check pair
87501Influenza dna amp prob 1+1Check pair
87631Resp virus 3-5 targets0Check pair
87632Resp virus 6-11 targets0Check pair
87633Resp virus 12-25 targets0Check pair
87636Sarscov2 & inf a&b amp prb1Check pair
87637Sarscov2&inf a&b&rsv amp prb1Check 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.