Data Platform
Sign InTry for Free

CPT 86162 Fee Schedule

Last Verified: December 2025

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

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$11.631407191984 - BSA HOSPITAL LLC300754305TXGeneral 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
86162$20.311063466035 - CHCA CLEAR LAKE LP, HCA HOUSTON HEALTHCARE CLEAR LAKE621801360TXGeneral Acute Care Hospital (282N00000X)
United
86162$20.311215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS954537720TXGeneral Acute Care Hospital (282N00000X)
United
86162$26.701689676835 - NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT, NATCHITOCHES REGIONAL MEDICAL CENTER726013916 - (LA) NATCHITOCHES REGIONAL MEDICAL CENTERLAGeneral Acute Care Hospital (282N00000X)
United
86162$11.921356320873 - EAST TEXAS MEDICAL CENTER ATHENS751854562 - (TX) ETX SUCCESSOR ATHENSTXGeneral Acute Care Hospital (282N00000X)
United
86162$20.311700885076 - TH HEALTHCARE, LTD, NACOGDOCHES MEDICAL CENTER760354630TXGeneral Acute Care Hospital (282N00000X)
United
86162$24.951104819366 - CHILDREN'S HOSPITAL720467503 - CHILDRENS HOSPITAL INCLAChildren's Hospital (282NC2000X)
United
86162$18.291104057694 - SPECIALISTS HOSPITAL SHREVEPORT, LLC208810573 - (LA) SPECIALISTS HOSPITAL SHREVEPORT, L.L.C.LAGeneral Acute Care Hospital (282N00000X)
United
86162$20.311184911877 - VHS BROWNSVILLE HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE452663071TXGeneral Acute Care Hospital (282N00000X)
United
86162$16.591467442418 - NORTHWEST TEXAS HEALTHCARE SYSTEM INC, NORTHWEST TEXAS HEALTHCARE SYSTEM232238976TXGeneral Acute Care Hospital (282N00000X)
United
86162$26.701689676835 - NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT, NATCHITOCHES REGIONAL MEDICAL CENTER726013916 - (LA) NATCHITOCHES REGIONAL MEDICAL CENTERLAGeneral Acute Care Hospital (282N00000X)
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$20.321073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
86162$25.891407947336 - CLHG-VILLE PLATTE LLC, MERCY REGIONAL MEDICAL CENTER824681222LAGeneral 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

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 86162) and we'll show you how you compare in 15 minutes or less.