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See a sample rate comparisonCPT 86153 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 19 - Off Campus Outpatient Hospital 11 - Office |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $33.07 national non-facility rate (2026) · View Medicare rates for 86153 |
| Medicaid Fee Schedule | $29.33 median of the 5 states in the free preview · View Medicaid rates for 86153 |
National average reimbursement for CPT 86153 by major payers:
$72.45
$21.93
$108.43
$76.11
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CPT 86153
5 of 25 sample ratesHigher to lower in this preview
Jimmy Caudell
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$21.37Published rateRichard Levine
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$21.37Published rateKejia Rosenfeld
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$21.37Published rateBailey Hartwig
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$18.17Published rateTaylor Devinney
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$18.17Published rate
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See a sample payer proposalCPT 86153 vs. Other Immunology Procedures Codes
The CPT 86153 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 86153 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 86153. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86153 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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