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CPT 86325 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.

Immunoelectrophoresis;Oth Fluids W Conce
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Immunology Procedures

Common Place of Service

22 - On Campus Outpatient Hospital

21 - Inpatient Hospital

Common Modifiers

None

26 - Professional component

90 - Reference Laboratory

Complexity LevelLow
CMS$17.14 Physician Fee Schedule

National average reimbursement for CPT 86325 by major payers:

bcbs

$24.07

uhc

$16.13

aetna

$25.22

cigna

$36.26

Preview provider-level rates for...
For billing codeCPT 86325
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 86325

United
86325$25.371730556259 - RAM SAHA541581185 - MCV ASSOCIATED PHYSICIANSTXGeneral Acute Care Hospital (282N00000X)
United
86325$27.451295772259 - LAKEVIEW MEDICAL CENTER, LLC, LAKEVIEW REGIONAL MEDICAL CENTER621596506LAGeneral Acute Care Hospital (282N00000X)
United
86325$13.111275581852 - ROLLING PLAINS MEMORIAL HOSPITAL756003896 - (TX) THE NOLAN COUNTY HOSPITAL DISTRICTTXGeneral Acute Care Hospital (282N00000X)
United
86325$27.761174526529 - TITUS COUNTY HOSPITAL DISTRICT, TITUS REGIONAL MEDICAL CENTER756003935TXGeneral Acute Care Hospital (282N00000X)
United
86325$23.121629021845 - ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP, NORTH AUSTIN MEDICAL CENTER742781812TXGeneral Acute Care Hospital (282N00000X)
United
86325$9.711407191984 - BSA HOSPITAL LLC300754305TXGeneral Acute Care Hospital (282N00000X)
United
86325$11.601295736734 - CHRISTUS HEALTH ARK-LA-TEX, CHRISTUS ST. MICHAEL HEALTH SYSTEM752796815 - CHRISTUS HEALTH ARK-LA-TEXTXGeneral Acute Care Hospital (282N00000X)
United
86325$31.231033168786 - HOUSTON VAMC760418077TXGeneral Acute Care Hospital (282N00000X)
United
86325$18.731609135904 - ANDREW CORONA273026151 - (TX) MID COAST MEDICAL CENTER-CENTRALTXGeneral Acute Care Hospital (282N00000X)
United
86325$27.761326079534 - CHILDRESS COUNTY HOSPITAL DISTRICT, CHILDRESS REGIONAL MEDICAL CENTER751228349TXGeneral Acute Care Hospital (282N00000X)
United
86325$12.801942292255 - TEXAS SPINE AND JOINT HOSPITAL, LLC, BAYLOR SCOTT & WHITE TX SPINE & JOINT HOS SUR CTR752951355 - (TX) TEXAS SPINE AND JOINT HOSPITALTXGeneral Acute Care Hospital (282N00000X)
United
86325$23.121659323772 - COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP, MEDICAL CITY FORT WORTH621682202 - (TX) COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LPTXGeneral Acute Care Hospital (282N00000X)
United
86325$23.121811942238 - KPH-CONSOLIDATION, INC., HCA HOUSTON HEALTHCARE NORTH CYPRESS A CAMPUS OF HCA HOUSTON HEALTHCAR621619857TXGeneral Acute Care Hospital (282N00000X)
United
86325$13.111932123247 - DALLAS COUNTY HOSPITAL DISTRICT, PARKLAND HEALTH756004221 - DALLAS COUNTY HOSPITAL DISTRICTTXGeneral Acute Care Hospital (282N00000X)
United
86325$75.001184042822 - WOODLANDS SPECIALTY HOSPITAL462263738 - (TX) WOODLANDS SPECIALTY HOSPITALTXGeneral 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 86325 vs. Other Immunology Procedures Codes

The CPT 86325 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 86325 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
86200-CPTLowCyclic Citrullinated Peptide Antibody
86316-CPTLowImmunoassay For Tumor Antigen; Other Antigen, Quantitative (Eg, Ca 50, 72-4, 549), Each
86320-CPTLowImmunoelectrophoresis Serum
86325-CPTLowImmunoelectrophoresis;Oth Fluids W Conce

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86325. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 86325 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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