What is CPT code 86140?

CPT code 86140 is a medical code used by healthcare providers to document and receive reimbursement for pathology and laboratory procedures, specifically for C-Reactive Protein (CRP) tests. It falls under immunology procedures and represents a moderate-complexity encounter.

What does the fee schedule for CPT 86140 include?

A fee schedule for CPT 86140 lists the fixed prices that healthcare providers charge for this specific service. It details reimbursement rates, which can vary based on payer type (Medicare, Medicaid, private insurance), geographic location, and specific provider contracts.

What factors influence the reimbursement rates for CPT 86140?

Several factors affect CPT 86140 reimbursement rates, including whether the payer is Medicare, Medicaid, or a private insurance company, the geographic location where the service is provided (e.g., urban vs. rural), and the type of provider (e.g., hospital vs. private practice).

How does CPT 86140 compare to other immunology procedure codes?

CPT 86140 is part of the Pathology and Laboratory Procedures services for Immunology Procedures. It generally represents a moderate-complexity encounter involving more provider time and medical decision-making compared to lower-level codes. This can include multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation.

Where can I view Medicare rates for CPT 86140?

You can view Medicare rates for CPT 86140 through the PayerPrice platform, specifically by looking up the Medicare fee schedule for the year 2025 and selecting the physician_ffs type.

CPT 86140 Fee Schedule

Last Verified: March 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.

C-Reactive Protein

Key Fact	Detail
Service Type	• Pathology and Laboratory Procedures • Immunology Procedures
Common Place of Service	• 81 - Independent Laboratory • 11 - Office
Common Modifiers	• None • 26 - Professional component • TC - Technical component
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 86140

National average reimbursement for CPT 86140 by major payers:

$4.48

$3.70

$6.69

$7.91

Preview provider-level rates for...

For billing codeCPT 86140

Payer	Code	Rate	NPI	Tax ID	State	Specialty
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 86140
United	86140	$2.18	1780676197 - V KOLLI	204941129 - (TX) DIGESTIVE HEALTH CLINIC OF EL PASO, P.A.	TX	Gastroenterology Physician (207RG0100X)
United	86140	$2.84	1255508289 - ROZINA MITHANI KUKREJA	756002868	TX	Gastroenterology Physician (207RG0100X)
United	86140	$3.03	1407849946 - DANIEL DARMADI	760194878 - (TX) GASTROENTEROLOGY CONSULTANTS, P.A.	TX	Gastroenterology Physician (207RG0100X)
United	86140	$8.88	1053548891 - AMIT MORI	450226711 - ST ALEXIUS MEDICAL CENTER	OH	Gastroenterology Physician (207RG0100X)
United	86140	$2.84	1568752756 - ANNA TAVAKKOLI	756002868	TX	Gastroenterology Physician (207RG0100X)
United	86140	$4.34	1265450811 - HUSSIEN ELSIESY	201244058 - FERRELL HOSPITAL COMMUNITY FOUNDATION	NY	Gastroenterology Physician (207RG0100X)
United	86140	$3.10	1386802957 - FRANCIS OKEKE	812336625	TX	Gastroenterology Physician (207RG0100X)
United	86140	$3.10	1134158736 - RICHARD SHAFFER	741967809 - (TX) GASTROENTEROLOGY CONSULTANTS OF SAN ANTONIO, P.A.	TX	Gastroenterology Physician (207RG0100X)
United	86140	$2.84	1033408182 - NICOLE RICH	756002868	TX	Gastroenterology Physician (207RG0100X)
United	86140	$1.69	1922033547 - CHA HOLLYWOOD MEDICAL CENTER, LP, HOLLYWOOD PRESBYTERIAN MEDICAL CENTER	300284087	CA	General Acute Care Hospital (282N00000X)
United	86140	$16.93	1396948824 - TINSAY WORETA	520595110 - JOHNS HOPKINS UNIVERSITY	TX	Gastroenterology Physician (207RG0100X)
United	86140	$3.03	1306166483 - AMILCAR MORALES CARDONA	752005254 - TEXAS DIGESTIVE DISEASE CONSULTANTS	TX	Gastroenterology Physician (207RG0100X)
United	86140	$2.18	1982718433 - EPHRAIM NSIEN	262466786	VA	Gastroenterology Physician (207RG0100X)
United	86140	$2.97	1396065645 - IMAD AHMAD	752896138 - MEDHEALTH	TX	Gastroenterology Physician (207RG0100X)
United	86140	$2.18	1912946484 - JESSICA TREVINO	264562522 - SETON FAMILY OF DOCTORS	TX	Gastroenterology Physician (207RG0100X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

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CPT 86140 vs. Other Immunology Procedures Codes

The CPT 86140 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 86140 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
86140-CPT	Low	C-Reactive Protein
86141-CPT	Low	C-Reactive Protein; High Sensitivity (Hscrp)
86160-CPT	Low	Complement Antigen Each Component
86162-CPT	Low	Complement Total Hemolytic (Ch50)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86140. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 86140 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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CPT 86140 Fee Schedule

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