CPT 86334 Fee Schedule
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.
| 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 | • None • 26 - Professional component • 90 - Reference Laboratory |
| Complexity Level | Low |
| CMS | $17.14 Physician Fee Schedule |
National average reimbursement for CPT 86334 by major payers:

$23.34

$16.49

$28.91

$35.74
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 86334 | ||||||
United | 86334 | $15.23 | 1104367630 - STEWARD MEDICAL GROUP, INC. | 272777455 | FL | Urology Physician (208800000X) |
United | 86334 | $9.38 | 1699783845 - WILLIAM ANDERSON | 237313346 - UNIVERSITY MEDICAL SERVICE ASSOCIATION INC | FL | Pulmonary Disease Physician (207RP1001X) |
United | 86334 | $11.42 | 1376525501 - MICHAEL LUSTGARTEN | 592215873 - (FL) MICHAEL E LUSTGARTEN MD PA | FL | Urology Physician (208800000X) |
United | 86334 | $18.26 | 1992718050 - RAHILA ESSANI | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Colon & Rectal Surgery Physician (208C00000X) |
United | 86334 | $9.38 | 1821043811 - BASIL FOSSUM MD PA | 593014004 - (FL) BASIL D FOSSUM MD PA | FL | Urology Physician (208800000X) |
United | 86334 | $33.40 | 1811335185 - CODY HILLIN | 590634433 - THE NEMOURS FOUNDATION | FL | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | 86334 | $9.38 | 1639240872 - CHELSY MARTY | 592949132 - (FL) DOUGLAS K PIERCE MD PA | FL | Dermatology Physician (207N00000X) |
United | 86334 | $12.80 | 1013396647 - GEORGE FILOSA | 462620381 - (FL) BAPTIST MD ANDERSON CANCER PHYSICIANS INC | FL | Colon & Rectal Surgery Physician (208C00000X) |
United | 86334 | $18.38 | 1063640068 - ABUBAKER ALI | 814061406 - (MI) UNITED TRAUMA CARE PLC | FL | Surgery Physician (208600000X) |
United | 86334 | $18.25 | 1124061890 - JANET COLLI | 461243081 | FL | Urology Physician (208800000X) |
United | 86334 | $8.03 | 1457485245 - RONA ALTARAS | 800649008 - (FL) WEST FLORIDA TRAUMA NETWORK LLC | FL | Surgery Physician (208600000X) |
United | 86334 | $18.26 | 1558356121 - STEPHEN MANDIA | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Urology Physician (208800000X) |
United | 86334 | $12.77 | 1023083177 - JOHN DALI | 593000333 - WHITE-WILSON MEDICAL CENTER, PA | FL | Surgery Physician (208600000X) |
United | 86334 | $8.40 | 1407016454 - MICHELLE GNIADY | 800951542 - VOHRA POST ACUTE CARE PHYSICIANS OF THE NORTHEAST PA | FL | Surgery Physician (208600000X) |
United | 86334 | $8.03 | 1407267693 - SHEA JONES | 880898308 - (FL) COASTLINE SURGICAL GROUP PLLC | FL | Surgery Physician (208600000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 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.
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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