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See a sample rate comparisonCPT 86356 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.
Mononuclear Cell Antign Quantita (Eg Flow Cytometry) Not Other, Mononuclear Cell Antigen Quantitative (Eg Flow Cytometry) Not Other
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | XE - Separate encounter 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $26.78 national lab fee schedule rate (2026) · View Medicare rates for 86356 |
| Medicaid Fee Schedule | $26.51 median of the 8 states in the free preview · View Medicaid rates for 86356 |
National average reimbursement for CPT 86356 by major payers:
$23.68
$17.91
$27.12
$60.83
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CPT 86356
5 of 25 sample ratesHigher to lower in this preview
Aakash Patel
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$16.06Published rateMokenge Malafa
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$16.06Published rateHeather Roulstone
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$13.65Published rateAshleigh Schroering
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$13.65Published rateStephanie Forbes
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$13.65Published rate
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See a sample payer proposalCPT 86356 vs. Other Immunology Procedures Codes
The CPT 86356 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 86356 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 |
|---|---|---|
| 86352-CPT | Low | Test For Biomarker, A General Test Of A Sample Of Cells Looking For A Biomarker. A Biomarker Is A Chemical Made By The Body That Is Important To A Specific Function. |
| 86353-CPT | Low | Test Of Immune Response, The Test Evaluates The Quality Of The Immune Systems Early Response Which Involves Lymphocytes (A Type Of White Blood Cell). The Test Can Help Evaluate Suspected Immune Deficiency. |
| 86355-CPT | Low | Blood B-Cell Count, This Test Counts B Cells (White Blood Cells Found In Bones) Which Are Markers For Immune System Function. They Help Physicians Understand The Bodys Needs For An Anticipated Transplant. |
| 86356-CPT | Low | Mononuclear Cell Antign Quantita (Eg Flow Cytometry) Not Other, Mononuclear Cell Antigen Quantitative (Eg Flow Cytometry) Not Other |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86356. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86356 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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