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See a sample rate comparisonCPT 86340 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.
Vitamin B12 Usage Test, The Test For Vitamin B12 Absorption Detects A Protein Called Intrinsic Factor That Should Be Present In The Stomach. B12 Is Used By Every Cell In The Body And Is Especially Important For The Brain Nervous System And Blood.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $15.08 national lab fee schedule rate (2026) · View Medicare rates for 86340 |
| Medicaid Fee Schedule | $14.89 median of the 8 states in the free preview · View Medicaid rates for 86340 |
National average reimbursement for CPT 86340 by major payers:
$13.51
$10.71
$17.75
$22.16
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CPT 86340
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$60.00Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$15.25Published ratePrisma Health-Upstate, Prisma Health Op Surgery Patewood
Prisma Health - Upstate
$13.56Published rateChristopher Raio
St Francis Hospital
$9.05Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$5.28Published rate
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See a sample payer proposalCPT 86340 vs. Other Immunology Procedures Codes
The CPT 86340 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 86340 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. |
| 86340-CPT | Low | Vitamin B12 Usage Test, The Test For Vitamin B12 Absorption Detects A Protein Called Intrinsic Factor That Should Be Present In The Stomach. B12 Is Used By Every Cell In The Body And Is Especially Important For The Brain Nervous System And Blood. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86340. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86340 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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