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See a sample rate comparisonCPT 86328 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | QW - CLIA Waived Tests CS - COVID-19 testing cost-sharing |
| Complexity Level | Low |
| Medicare Fee Schedule | $45.28 national lab fee schedule rate (2026) · View Medicare rates for 86328 |
| Medicaid Fee Schedule | $41.66 median of the 8 states in the free preview · View Medicaid rates for 86328 |
National average reimbursement for CPT 86328 by major payers:
$38.35
$37.05
$50.94
$68.84
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CPT 86328
5 of 25 sample ratesHigher to lower in this preview
Ria Gripaldo
Emory University
$76.58Published rateMario Ponce Alvarez
Morehouse Healthcare Inc
$45.22Published rateAnsible Health Medical Group PA
$38.45Published rateMatthew Varner
Prisma Health Medical Group-Midlands
$27.13Published rateAnsible Health Medical Group PA
$27.13Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86328 vs. Other Immunology Procedures Codes
The CPT 86328 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 86328 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 |
|---|---|---|
| 86318-CPT | Low | Immunity Test, Immunity Tests Identify Specific Antibodies And Measure The Level Of Immunity (Resistance) That The Antibody Provides. This Test Can Be Used To Assess The Effectiveness Of A Vaccination. |
| 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 |
| 86329-CPT | Low | Antibody-Antigen Lab Test, This Antibody-Antigen Lab Test Is Used To Help Identify Many Different Diseases Or Infections. |
| 86331-CPT | Low | Immunodiffusion; Gel Diffusion Qualitat (Ouchterlony) Ea Antige, Immunodiffusion; Gel Diffusion Qualitative (Ouchterlony) Each Antige |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86328. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86328 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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