Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 86156 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.
Blood Clumping Test, This Test Evaluates Blood At A Low Temperature. A Type Of Immune Cell Called A Cold Agglutinin Causes Red Blood Cells To Clump Together. If Many Are Present In A Sample This Can Point Toward A Diagnosis.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $8.07 national lab fee schedule rate (2026) · View Medicare rates for 86156 |
| Medicaid Fee Schedule | $7.685 median of the 8 states in the free preview · View Medicaid rates for 86156 |
National average reimbursement for CPT 86156 by major payers:
$6.85
$5.14
$8.16
$11.60
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 86156.
CPT 86156
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$35.00Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$8.07Published ratePrisma Health-Upstate, Prisma Health Op Surgery Patewood
Prisma Health - Upstate
$7.26Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$6.78Published rateVictory Medical Center Landmark, Lp
$2.91Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 86156 vs. Other Immunology Procedures Codes
The CPT 86156 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 86156 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 |
|---|---|---|
| 86053-CPT | Low | Test For Devics Disease, Lab Test For Antibodies That Help To Diagnose Neuromyelitis Optica Also Known As Devics Disease. This Is A Rare Condition Where The Immune System Damages The Spinal Cord And The Nerves Of The Eyes. |
| 86060-CPT | Low | Test For Strep Complications, This Test Detects Antibodies To A Previous Strep Infection. It Is Done To Identify A Complication Of The Strep Infection Such As Rheumatic Fever Or Kidney Disease. |
| 86156-CPT | Low | Blood Clumping Test, This Test Evaluates Blood At A Low Temperature. A Type Of Immune Cell Called A Cold Agglutinin Causes Red Blood Cells To Clump Together. If Many Are Present In A Sample This Can Point Toward A Diagnosis. |
| 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. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86156. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86156 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 86156) and we'll show you how you compare in 15 minutes or less.