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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 | 22 - On Campus Outpatient Hospital 81 - Independent Laboratory |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $22.34 national lab fee schedule rate (2026) · View Medicare rates for 86334 |
| Medicaid Fee Schedule | $20.83 median of the 8 states in the free preview · View Medicaid rates for 86334 |
National average reimbursement for CPT 86334 by major payers:

$23.34

$16.49

$28.91

$34.31
Choose a payer to see a sample of rates for CPT 86334.
Rahila Essani
Florida Hospital Medical Group Inc
Nicolas Aguila
Timothy Juwono
California Cancer Associates For Research And Excellence, Inc.
Elizabeth Myers
Baycare Medical Group Inc
Khongruk Wongkittiroch
South Florida Surgical Specialists LLC
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Rate Benchmarking
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See a sample payer proposalCPT 86334 vs. Other Immunology Procedures Codes
The CPT 86334 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 86334 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 |
|---|---|---|
| 86332-CPT | Low | Immune Pair Testing, An Immune Complex Is An Antibody Attached To Its Corresponding Antigen. This Test Identifies All Pairs Present In A Blood Sample. Immune Complexes Play A Role In Autoimmune Diseases. |
| 86334-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. |
| 86335-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. |
| 86336-CPT | Low | Down Syndrome Screening, Blood Test For Inhibin A Taken During The 16th To 18th Week Of Pregnancy To Screen For Down Syndrome. Results Usually Are Combined With Those From Three Other Tests (Afp Hcg And Estriol). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86334. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86334 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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