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See a sample rate comparisonCPT 0886T Fee Schedule
CPT 0886T is classified under Category III Codes, in the Transendoscopic Mechanical Dilation Procedures subgroup.
Sgmdsc Flx 1st Tndsc Dilat, Sigmoidoscopy Flexible With Initial Transendoscopic Mechanical Dilation (Eg Nondrug-Coated Balloon) Followed By Therapeutic Drug Delivery By Drug-Coated Balloon Catheter For Colonic Stricture Including Fluoroscopic Guidance When Performed
| Key Fact | Detail |
|---|---|
| Service Type | Category III Codes Transendoscopic Mechanical Dilation Procedures |
| Hospital Outpatient Group (APC) | APC 5331 - Complex GI Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 03600361Sign up to view all 18 |
| Medicare Fee Schedule | View Medicare rates for 0886T |
| Medicaid Fee Schedule | $211.355 median of the 2 states in the free previewView Medicaid rates for 0886T |
National average reimbursement for CPT 0886T by major payers:
$2,032.57
BCBS / Anthem
$1,075.94
UnitedHealthcare
$1,648.23
Aetna
$N/A
Cigna
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CPT 0886T
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Health System
$13,029.00Published rateTh Healthcare, Ltd, Nacogdoches Medical Center
$9,140.00Published rateTexas Health Harris Methodist Hospital Southwest Fort Worth
$8,320.00Published rateVhs San Antonio Partners, LLC
$5,159.00Published rateThibodaux Surgery Center, LLC, Bayou Region Surgical Center
Thibodaux Surgery Center, LLC Dba Bayou Region Surgical Center
$1,142.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 0886T vs. Other Transendoscopic Mechanical Dilation Procedures Codes
| Code | Description |
|---|---|
| 0886T-CPT | Sgmdsc Flx 1st Tndsc Dilat, Sigmoidoscopy Flexible With Initial Transendoscopic Mechanical Dilation (Eg Nondrug-Coated Balloon) Followed By Therapeutic Drug Delivery By Drug-Coated Balloon Catheter For Colonic Stricture Including Fluoroscopic Guidance When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0886T. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0886T fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
What APC is CPT 0886T assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 0886T to APC 5331 (Complex GI Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 0886T in an ambulatory surgery center?
CMS lists CPT 0886T with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 0886T?
Hospital price transparency files list CPT 0886T under these revenue codes: including 0360, 0361, 0450, 0490 and 0510. A revenue code names the hospital department or charge category for the line; it does not change what the service is.