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CPT 86200 Fee Schedule

Last Verified: January 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.

Cyclic Citrullinated Peptide Antibody
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 86200

National average reimbursement for CPT 86200 by major payers:

bcbs

$11.24

uhc

$9.28

aetna

$15.77

cigna

$46.67

Preview provider-level rates for...
For billing codeCPT 86200
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 86200

United
86200$12.941902857766 - COLUMBIA MEDICAL CENTER OF LAS COLINAS INC, MEDICAL CITY LAS COLINAS621650582 - (TX) COLUMBIA MEDICAL CENTER OF LAS COLINAS INCTXGeneral Acute Care Hospital (282N00000X)
United
86200$12.941932204427 - NMC OPERATING COMPANY LLC, THE SPINE HOSPITAL OF LOUISIANA270059959 - (LA) NMC OPERATING COMPANY, LLCLAGeneral Acute Care Hospital (282N00000X)
United
86200$7.591134126659 - CALDWELL MEMORIAL HOSPITAL INC720878037 - (LA) CALDWELL MEMORIAL HOSPITAL, INC.LAGeneral Acute Care Hospital (282N00000X)
United
86200$15.891497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL621596506LAGeneral Acute Care Hospital (282N00000X)
United
86200$5.441356905129 - YAWEN REN760459500 - U T PHYSICIANSTXRheumatology Physician (207RR0500X)
United
86200$12.941275506115 - SPRINGHILL MEDICAL SERVICES, INC., SPRINGHILL MEDICAL CENTER721479692 - SPRINGHILL MEDICAL SERVICES INCLAGeneral Acute Care Hospital (282N00000X)
United
86200$12.941598744856 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST MEDICAL CENTER760714523TXGeneral Acute Care Hospital (282N00000X)
United
86200$5.441497275853 - ALEXANDER TRAN MD PA821967465 - (TX) ALEXANDER TRAN MD PATXGeneral Acute Care Hospital (282N00000X)
United
86200$6.031649361627 - HILDA DRAEGER742932237 - (TX) COMMUNITY MEDICINE ASSOCIATESTXRheumatology Physician (207RR0500X)
United
86200$7.591861802704 - MAUSHMI SAVJANI202798379 - (TX) CLEAR LAKE SPECIALTIES, PATXRheumatology Physician (207RR0500X)
United
86200$6.711740453000 - GRAHAM REGIONAL MEDICAL CENTER, GRAHAM GENERAL HSOPITAL PHYSICIANS463113489TXGeneral Acute Care Hospital (282N00000X)
United
86200$7.691033232418 - BERNARD HILDEBRAND742889447TXRheumatology Physician (207RR0500X)
United
86200$5.441942356563 - KEVIN OSGOOD881180756TXRheumatology Physician (207RR0500X)
United
86200$16.511407947336 - CLHG-VILLE PLATTE LLC, MERCY REGIONAL MEDICAL CENTER824681222LAGeneral Acute Care Hospital (282N00000X)
United
86200$12.941457994188 - VHS HARLINGEN HOSPITAL COMPANY, LLC, VALLEY BAPTIST MICRO-HOSPITAL WESLACO452662980TXGeneral 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 86200 vs. Other Immunology Procedures Codes

The CPT 86200 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 86200 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
86141-CPTLowC-Reactive Protein; High Sensitivity (Hscrp)
86200-CPTLowCyclic Citrullinated Peptide Antibody
86235-CPTLowImmunology Extractable Nuclear Antigen, Antibody To, An Method (Eg, Nrnp, Ss-A, Ss-B, Sm, Rnp, Sc170, J01) Each Antibody

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 86200 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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