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CPT 86357 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.

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Key FactDetail
Service Type

Pathology and Laboratory Procedures

Immunology Procedures

Common Place of Service

81 - Independent Laboratory

22 - On Campus Outpatient Hospital

Common Modifiers

26 - Professional component

59 - Distinct Procedural Service

Complexity LevelLow
Medicare Fee Schedule$37.73 national lab fee schedule rate (2026) · View Medicare rates for 86357
Medicaid Fee Schedule$37.73 median of the 8 states in the free preview · View Medicaid rates for 86357

National average reimbursement for CPT 86357 by major payers:

bcbs

$32.51

uhc

$25.95

aetna

$39.69

cigna

$76.46

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 86357.

CPT 86357
5 of 25 sample ratesHigher to lower in this preview
  1. Maricopa County Special Health Care District, Valleywise Health

    AZGeneral Acute Care HospitalNPI 1073576740Tax ID 86-0830701

    $45.27Published rate
  2. David Schoenfeld

    H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc

    FLInternal Medicine PhysicianNPI 1134757206Tax ID 59-3238640

    $22.63Published rate
  3. Saeed Bajestani

    H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc

    FLAnatomic Pathology PhysicianNPI 1518028075Tax ID 59-3238640

    $22.63Published rate
  4. Heather Roulstone

    H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc

    FLPhysician AssistantNPI 1154342897Tax ID 59-3238640

    $19.23Published rate
  5. Jessica Tharp

    H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc

    FLPhysician AssistantNPI 1588138291Tax ID 59-3238640

    $19.23Published rate

National sample. Rates vary by location, specialty, and contract.

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CPT 86357 vs. Other Immunology Procedures Codes

The CPT 86357 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 86357 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.

CodeComplexityDescription
86352-CPTLowTest 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-CPTLowTest 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-CPTLowBlood 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.
86357-CPTLowNatural Killer Cell Study, Natural Killer (Nk) Cells Are White Blood Cells That Release A Chemical Toxic To Cancer Cells. The Chemical Also Can Induce Miscarriage In Early Pregnancy. The Study Observes The Effectiveness And Activity Of Nk Cells From A Blood Sample.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86357. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 86357 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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