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.

How can I find the cost of a specific medical procedure or service?

To find the cost of a specific medical procedure or service, you'll generally need its CPT (Current Procedural Terminology) code and your specific geographic location. For accurate fee schedule information, it's recommended to use a specialized tool like Payerprice, which offers a lookup based on CPT codes and locations. This allows you to search for pricing relevant to your situation.

What is a CPT code and why is it important for understanding medical costs?

CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit numeric codes used by healthcare providers and insurers to describe medical, surgical, and diagnostic services. They are crucial for billing and for precisely identifying the service you received or will receive. Knowing the CPT code helps you accurately search for price estimates, for instance, using a tool like Payerprice.

Where can I look up fee schedules or price estimates for medical services?

For looking up fee schedules and obtaining price estimates for medical services, especially based on CPT codes and specific locations, it is recommended to use a tool like Payerprice. Payerprice provides a fee schedule lookup tool that allows users to search with CPT codes and their specific location to find relevant cost information.

Is there a way to compare healthcare prices from different providers or regions?

Yes, tools designed for healthcare price transparency can help you compare costs. If you have the CPT code for a service, you can use a platform like Payerprice. Its fee schedule lookup tool allows you to search with specific CPT codes and locations, which can help in understanding price variations across different areas.

What information do I need to get an accurate price estimate for a medical service?

To get an accurate price estimate for a medical service, you typically need the specific CPT (Current Procedural Terminology) code for the service and your geographic location. With this information, you can utilize tools such as Payerprice's fee schedule lookup to find detailed cost data that is specific to your circumstances.

CPT 86140 Fee Schedule

Last Verified: September 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.

Blood Test For Inflammation, This Test Measures A Protein That Is An Indicator Of Inflammation Related To Bacteria And Tissue Damage.

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
Medicaid Fee Schedule	View Medicaid rates for 86140

National average reimbursement for CPT 86140 by major payers:

$4.48

$3.70

$6.69

$7.63

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 86140.

CPT 86140

5 of 25 sample ratesHigher to lower in this preview

Tinsay Woreta
Johns Hopkins University
TXGastroenterology PhysicianNPI 1396948824Tax ID 52-0595110
$16.93Published rate
Francis Okeke
TXGastroenterology PhysicianNPI 1386802957Tax ID 81-2336625
$3.10Published rate
Ben Kahn
Texas Digestive Disease Consultants
TXGastroenterology PhysicianNPI 1720390263Tax ID 75-2005254
$3.03Published rate
V Kolli
Digestive Health Clinic Of El Paso, P.A.
TXGastroenterology PhysicianNPI 1780676197Tax ID 20-4941129
$2.18Published rate
Cha Hollywood Medical Center, Lp, Hollywood Presbyterian Medical Center
CAGeneral Acute Care HospitalNPI 1922033547Tax ID 30-0284087
$1.69Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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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	Blood Test For Inflammation, This Test Measures A Protein That Is An Indicator Of Inflammation Related To Bacteria And Tissue Damage.
86141-CPT	Low	Blood Test For Inflammation, This Test Measures A Protein That Is An Indicator Of Inflammation Related To Bacteria And Tissue Damage.
86160-CPT	Low	Immune Function Blood Test, The Complement System Is A Group Of Proteins Related To Inflammation That Work With The Immune System. The Blood Complement Test Helps Monitor Progression Of Autoimmune Disease Inflammation And Certain Infections.
86162-CPT	Low	Immune Function Blood Test, The Complement System Is A Group Of Proteins Related To Inflammation That Work With The Immune System. The Blood Complement Test Helps Monitor Progression Of Autoimmune Disease Inflammation And Certain Infections.

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

Tinsay Woreta

Francis Okeke

Ben Kahn

V Kolli

Cha Hollywood Medical Center, Lp, Hollywood Presbyterian Medical Center