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CPT 86162 Fee Schedule

Last Verified: March 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.

Complement Total Hemolytic (Ch50)
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Immunology Procedures

Common Place of Service

81 - Independent Laboratory

11 - Office

Common Modifiers

None

90 - Reference Laboratory

26 - Professional component

Complexity LevelLow
Medicare Fee ScheduleView Medicare rates for 86162

National average reimbursement for CPT 86162 by major payers:

bcbs

$18.19

uhc

$14.51

aetna

$23.30

cigna

$30.53

Preview provider-level rates for...
For billing codeCPT 86162
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 86162

United
86162$8.521720033947 - ST. DAVIDS HEALTHCARE PARTNERSHIP, L.P., LLP, HEART HOSPITAL OF AUSTIN743001674 - (TX) LONE STAR CIRCLE OF CARETXGeneral Acute Care Hospital (282N00000X)
United
86162$60.001003344334 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE HORIZON CITY CAMPUS813935393 - (TX) HCN EP HORIZON CITY LLCTXGeneral Acute Care Hospital (282N00000X)
United
86162$11.631508199621 - SERGE LARTCHENKO M.D., PLLC270839735 - (TX) SERGE LARTCHENKO MD PLLCTXGeneral Acute Care Hospital (282N00000X)
United
86162$20.311861994808 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE NORTHEAST CAMPUS813935393 - (TX) HCN EP HORIZON CITY LLCTXGeneral Acute Care Hospital (282N00000X)
United
86162$18.291942294939 - ST JOSEPH REGIONAL HEALTH CENTER, ST JOSEPH AMBULATORY SURGERY741282696 - ST JOSEPH REGIONAL HEALTH CENTERTXGeneral Acute Care Hospital (282N00000X)
United
86162$8.531053866707 - BRITTANY PTACHICK541958039 - HROA 401K PLANVAFamily Nurse Practitioner (363LF0000X)
United
86162$29.671801825005 - HOSPITAL SERVICE DISTRICT #2 OF LASALLE PARISH, LASALLE GENERAL HOSPITAL720690217 - (LA) HOSPITAL SERVICE DISTRICT 2 OF LASALLE PARISHLAGeneral Acute Care Hospital (282N00000X)
United
86162$25.541245878990 - HUNTSVILLE COMMUNITY HOSPITAL, INC.843654542 - (TX) HUNTSVILLE COMMUNITY HOSPITAL INCTXGeneral Acute Care Hospital (282N00000X)
United
86162$18.291104057694 - SPECIALISTS HOSPITAL SHREVEPORT, LLC208810573 - (LA) SPECIALISTS HOSPITAL SHREVEPORT, L.L.C.LAGeneral Acute Care Hospital (282N00000X)
United
86162$20.311982604021 - GEORGETOWN MEMORIAL HOSPITAL, TIDELANDS GEORGETOWN MEMORIAL HOSPITAL570341194 - GEORGETOWN MEMORIAL HOSPITALSCGeneral Acute Care Hospital (282N00000X)
United
86162$60.001225381197 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL HAUSMAN452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLCTXGeneral Acute Care Hospital (282N00000X)
United
86162$11.921275581852 - ROLLING PLAINS MEMORIAL HOSPITAL756003896 - (TX) THE NOLAN COUNTY HOSPITAL DISTRICTTXGeneral Acute Care Hospital (282N00000X)
United
86162$12.221790777696 - JACK COUNTY HOSPITAL DISTRICT, FAITH COMMUNITY HOSPITAL756004585 - (TX) FAITH COMMUNITY HOSPITALTXGeneral Acute Care Hospital (282N00000X)
United
86162$20.311811942238 - KPH-CONSOLIDATION, INC., HCA HOUSTON HEALTHCARE NORTH CYPRESS A CAMPUS OF HCA HOUSTON HEALTHCAR621619857TXGeneral Acute Care Hospital (282N00000X)
United
86162$18.291467496802 - ST FRANCIS HOSPITAL, INC., ST. FRANCIS EASTSIDE582504530 - (SC) ST FRANCIS HOSPITAL INCSCGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 86162 vs. Other Immunology Procedures Codes

The CPT 86162 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 86162 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.

CodeComplexityDescription
86140-CPTLowC-Reactive Protein
86160-CPTLowComplement Antigen Each Component
86161-CPTLowComplement Functional Activ Ea Comp
86162-CPTLowComplement Total Hemolytic (Ch50)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86162. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 86162 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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