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See a sample rate comparisonCPT 86341 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.
Insulin Production Test, This Test Determines Whether The Pancreas Is Producing Insulin Which Is Helpful In Diagnosing Diabetes.
| 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 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $23.57 national lab fee schedule rate (2026) · View Medicare rates for 86341 |
| Medicaid Fee Schedule | $23.275 median of the 8 states in the free preview · View Medicaid rates for 86341 |
National average reimbursement for CPT 86341 by major payers:
$18.91
$23.47
$25.40
$33.42
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CPT 86341
5 of 25 sample ratesHigher to lower in this preview
Ram Saha
Mcv Associated Physicians
$31.45Published rateChca West Houston L P, Hca Houston Healthcare West
Chca West Houston L P
$23.56Published rateChca Clear Lake Lp, Hca Houston Healthcare Clear Lake
$23.56Published rateSt Helena Parish Hospital, St Helena Parish Hospital
St Helena Parish Hospital
$17.00Published rateEastland Memorial Hospital District, Eastland Memorial Hospital
$9.89Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86341 vs. Other Immunology Procedures Codes
The CPT 86341 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 86341 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. |
| 86341-CPT | Low | Insulin Production Test, This Test Determines Whether The Pancreas Is Producing Insulin Which Is Helpful In Diagnosing Diabetes. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86341. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86341 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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