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See a sample rate comparisonCPT 86146 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 Blood Condition, The Test Looks For Antibodies That Are Present In Aps (Antiphospholipid) Syndrome. Aps Causes Abnormal Blood Clotting With A Low Platelet Count And Greatly Increases The Likelihood Of Miscarriage.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | $25.45 national lab fee schedule rate (2026) · View Medicare rates for 86146 |
| Medicaid Fee Schedule | $25.13 median of the 8 states in the free preview · View Medicaid rates for 86146 |
National average reimbursement for CPT 86146 by major payers:
$21.26
$17.12
$27.58
$36.68
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CPT 86146
5 of 25 sample ratesHigher to lower in this preview
Lasalle Parish Hospital Service Dist No1, Hardtner Medical Center
Hardtner Medical Center
$47.13Published rateChca Conroe Lp, Conroe Regional Medical Center
Chca Conroe Lp
$25.45Published rateAd Hospital East, LLC
$25.45Published ratePrisma Health-Upstate, Prisma Health Transplant Center
Prisma Health - Upstate
$22.90Published rateBsa Hospital LLC
$10.68Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86146 vs. Other Immunology Procedures Codes
The CPT 86146 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 86146 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 |
|---|---|---|
| 86146-CPT | Low | Test For Blood Condition, The Test Looks For Antibodies That Are Present In Aps (Antiphospholipid) Syndrome. Aps Causes Abnormal Blood Clotting With A Low Platelet Count And Greatly Increases The Likelihood Of Miscarriage. |
| 86147-CPT | Low | Test For Blood Condition, The Test Detects Antibodies That Cause Blood To Clot Spontaneously. This Can Result In Abnormal Blood Clotting Low Platelet Counts Or Repeated Miscarriages. This Test Is Specific For Anticardiolipin Antibodies Which Are Often Present With Lupus. |
| 86148-CPT | Low | Cell Death Study, This Study Examines The Process By Which Old Cells Die Off And Determines Whether Apparently Healthy Cells Are Dying. |
| 86225-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 86146. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86146 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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