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See a sample rate comparisonHealthcare 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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | QW - CLIA Waived Tests 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $5.18 national lab fee schedule rate (2026) · View Medicare rates for 86308 |
| Medicaid Fee Schedule | $5.115 median of the 8 states in the free preview · View Medicaid rates for 86308 |
National average reimbursement for CPT 86308 by major payers:

$5.02

$4.83

$6.73

$7.73
Choose a payer to see a sample of rates for CPT 86308.
Stacey Allen
Viemed Clinical Services LLC
James Christensen
Mountain View Hospital LLC
Leyla Nasehi
Family First Medical Center PLLC
William Strimel
Family First Medical Center PLLC
William Figlesthaler
Inspire Oncology LLC
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 86308 vs. Other Immunology Procedures Codes
The CPT 86308 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 86308 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 |
|---|---|---|
| 86308-CPT | Low | Heterophile Antibodies Screen, Heterophile Antibodies Screening (Closest Clinicallyequivalent Code(S) Deleted In 1993 86300) Heterophile Antibodies Screening (Closest Clinically |
| 86309-CPT | Low | Heterophile Antibodies Titer, Heterophile Antibodies Titer (Closest Clinically Equivalentcode(S) Deleted In 1993 86305) Heterophile Antibodies Titer (Closest Clinically Equivalent |
| 86310-CPT | Low | Heterophile Antibodies Titers, Heterophile Antibodies Titers After Absorption With Beefcells And Guinea Pig Kidney Heterophile Antibodies Titers After Absorption With Beef |
| 86316-CPT | Low | Cancer Treatment Assessment, This Assessment Uses A Radioactive Substance To Highlight Specific Antigens (Seen By The Immune System As Not Belonging In The Body). Antigens That Form With Tumors Can Help Determine How Well A Treatment Has Worked. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86308. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86308 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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