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See a sample rate comparisonCPT 86325 Fee Schedule
Last Verified: October 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.
Test Of Immune Activity, This Test Helps Diagnose And Monitor Multiple Diseases. It Measures A Decrease Or Increase Of Immune System Proteins (Globulins). The Sample Can Be Blood Urine Or Spinal Fluid.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $23.13 national lab fee schedule rate (2026) · View Medicare rates for 86325 |
| Medicaid Fee Schedule | $20.00 median of the 8 states in the free preview · View Medicaid rates for 86325 |
National average reimbursement for CPT 86325 by major payers:
$24.07
$16.13
$25.22
$34.83
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CPT 86325
5 of 25 sample ratesHigher to lower in this preview
Emerus Bhs Sa Thousand Oaks LLC, Baptist Neighborhood Hospital Shavano Park
Emerus Bhs Sa Thousand Oaks LLC
$75.00Published rateRam Saha
Mcv Associated Physicians
$25.37Published rateKph-Consolidation, Inc., Hca Houston Healthcare North Cypress A Campus Of Hca Houston Healthcar
$23.12Published rateEl Paso County Hospital District, University Medical Center Of El Paso
El Paso County Hospital District
$13.30Published rateEctor County Hospital District, Medical Center Hospital
$8.02Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 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. |
| 86320-CPT | Low | Test Of Immune Activity, This Test Helps Diagnose And Monitor Multiple Diseases. It Measures A Decrease Or Increase Of Immune System Proteins (Globulins). The Sample Can Be Blood Urine Or Spinal Fluid. |
| 86325-CPT | Low | Test Of Immune Activity, This Test Helps Diagnose And Monitor Multiple Diseases. It Measures A Decrease Or Increase Of Immune System Proteins (Globulins). The Sample Can Be Blood Urine Or Spinal Fluid. |
| 86328-CPT | Low | Ia Nfct Ab Sarscov2 Covid19, Immunoassay For Infectious Agent Antibody Ies Qualitative Or Semiquantitative Single Step Method Eg Reagent Strip Severe Acute Respiratory Syndrome Coronavirus 2 Sars Cov 2 Coronavirus Disease Covid 19 |
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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