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 86160 Fee Schedule
Medicare rates as of January 2026
CPT 86160 is classified under Pathology and Laboratory Procedures, in the Immunology Procedures subgroup.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 91 - Repeat Lab Test 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $12.00 national lab fee schedule rate (2026) · View Medicare rates for 86160 |
| Medicaid Fee Schedule | $11.85 median of the 8 states in the free preview · View Medicaid rates for 86160 |
National average reimbursement for CPT 86160 by major payers:
$10.54
BCBS / Anthem
$9.33
UnitedHealthcare
$14.45
Aetna
$17.63
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 86160.
CPT 86160
5 of 25 sample ratesHigher to lower in this preview
Pmc Hospital, LLC, St. Luke'S Patients Medical Center
Pmc Hospital, LLC
$22.21Published rateTenet Hospitals Limited, The Hospitals Of Providence Sierra Campus
$12.00Published rateKaren Allard
Slocum Dickson Medical Group PLLC
$9.97Published rateUhs Of Texoma, Inc, Texoma Medical Center
Uhs Of Texoma Inc
$6.86Published rateJulia Ross
Slocum Dickson Medical Group PLLC
$5.03Published 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 86160 vs. Other Immunology Procedures Codes
The table lists codes related to 86160. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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. |
| 86161-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. |
| 86171-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 86160. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86160 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 86160) and we'll show you how you compare in 15 minutes or less.