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See a sample rate comparisonCPT 86152 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.
Count Of Cells In Fluid Sample, A Lab Test That Counts The Number Of A Specific Type Of Cells In A Sample Of Fluid. For Example The Test May Be Used To Count Tumor Cells In A Blood Sample.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments Q1 - Routine clinical service provided in a clinical research study 26 - Professional component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $250.78 national lab fee schedule rate (2026) · View Medicare rates for 86152 |
| Medicaid Fee Schedule | $248.27 median of the 8 states in the free preview · View Medicaid rates for 86152 |
National average reimbursement for CPT 86152 by major payers:
$201.34
$152.69
$291.04
$377.02
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CPT 86152
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$551.72Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$331.03Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$250.78Published rateAaron Askew
Desert Bone & Joint Specialists, LLP
$140.57Published rateBaptist Health Care, Inc., Baptist Home Healt Care And Medical Equipment
Baptist Health Care Inc
$89.18Published rate
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See a sample payer proposalCPT 86152 vs. Other Immunology Procedures Codes
The CPT 86152 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 86152 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 |
|---|---|---|
| 86152-CPT | Moderate | Count Of Cells In Fluid Sample, A Lab Test That Counts The Number Of A Specific Type Of Cells In A Sample Of Fluid. For Example The Test May Be Used To Count Tumor Cells In A Blood Sample. |
| 86153-CPT | Low | Cell Enumeration Phys Interp, Cell Enumeration Using Immunologic Selection And Identification In Fluid Specimen Eg Circulating Tumor Cells In Blood Physician Interpretation And Report When Required |
| 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. |
| 86900-CPT | Low | Blood Typing, This Test Combines A Sample Of Whole Blood With Types 0 A B And Ab. By Observing Which Combinations Cause Blood Cells To Clump A Technician Can Match The Sample To A Type. The Test Is Done Before Giving A Transfusion. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86152. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86152 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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