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See a sample rate comparisonCPT 86060 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Test For Strep Complications, This Test Detects Antibodies To A Previous Strep Infection. It Is Done To Identify A Complication Of The Strep Infection Such As Rheumatic Fever Or Kidney Disease.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $7.30 national lab fee schedule rate (2026) · View Medicare rates for 86060 |
| Medicaid Fee Schedule | $7.21 median of the 8 states in the free preview · View Medicaid rates for 86060 |
National average reimbursement for CPT 86060 by major payers:
$6.47
$5.15
$8.68
$10.75
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CPT 86060
5 of 25 sample ratesHigher to lower in this preview
Sunland Medical Foundation, Trinity Regional Hospital Sachse
Sunland Medical Foundation
$18.00Published rateSt Davids Healthcare Partnership Lp LLP, North Austin Medical Center
$7.30Published rateKnox County Hospital District, Knox County Hospital District
$6.57Published rateMother Frances Hospital Regional Health Care Center, Christus Mother Frances Hospital Tyler
Mother Frances Hospital Regional Health Care Center
$4.38Published rateKarlie Ryan
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$3.06Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86060 vs. Other Immunology Procedures Codes
The CPT 86060 code is part of the Pathology and Laboratory Procedures services used for Immunology Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 86060 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 86060-CPT | Low | Test For Strep Complications, This Test Detects Antibodies To A Previous Strep Infection. It Is Done To Identify A Complication Of The Strep Infection Such As Rheumatic Fever Or Kidney Disease. |
| 86063-CPT | Low | Test For Strep Complications, This Test Detects Antibodies To A Previous Strep Infection. It Is Done To Identify A Complication Of The Strep Infection Such As Rheumatic Fever Or Kidney Disease. |
| 86155-CPT | Low | Immune Function Test, This Test Is Used To Assess The Ability Of The Immune System To Respond To A Foreign Bacteria. It Measures Chemotaxis Where Immune Cells Are Able To Recognize Bacteria Single Them Out And Move Toward Them As A Group. |
| 86215-CPT | Low | Autoimmune Disease Test, This Test Is Performed When Autoimmune Disease Involving Connective Tissue Is Suspected. The Test Identifies When An Immune System Creates Dna Antibodies To Destroy The Bodys Own Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86060. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86060 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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