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See a sample rate comparisonCPT 86362 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.
Test For Autoimmune Disorder, This Test Looks For Antibodies That Are Present In Myelin-Oligodendrocyte Glycoprotein Antibody-Associated Disease (Mogad) An Autoimmune Disorder.
| 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 | $12.05 national lab fee schedule rate (2026) · View Medicare rates for 86362 |
| Medicaid Fee Schedule | $11.78 median of the 8 states in the free preview · View Medicaid rates for 86362 |
National average reimbursement for CPT 86362 by major payers:
$10.51
$7.25
$20.25
$43.71
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CPT 86362
5 of 25 sample ratesHigher to lower in this preview
Robert Koffie
Neuroscience Group Of Northeast Wisconsin, S.C.
$29.68Published rateDaniel Dahle
Neuroscience Group Of Northeast Wisconsin, S.C.
$29.68Published rateDecatur Health Services, LLC
$12.05Published rateKph-Consolidation, Inc., Hca Houston Healthcare North Cypress A Campus Of Hca Houston Healthcar
$12.05Published rateVal Verde Hospital Corporation, Val Verde Regional Medical Center
Val Verde Hospital Corporation
$5.05Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86362 vs. Other Immunology Procedures Codes
The CPT 86362 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 86362 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 |
|---|---|---|
| 86360-CPT | Low | Blood T-Cell Count, This Test Counts T Cells A Type Of White Blood Cell. T Cells Help The Body Fight Diseases And Are Key To Evaluating Overall Function Of The Immune System. |
| 86361-CPT | Low | Blood T-Cell Count, This Test Counts T Cells A Type Of White Blood Cell. T Cells Help The Body Fight Diseases And Are Key To Evaluating Overall Function Of The Immune System. |
| 86362-CPT | Low | Test For Autoimmune Disorder, This Test Looks For Antibodies That Are Present In Myelin-Oligodendrocyte Glycoprotein Antibody-Associated Disease (Mogad) An Autoimmune Disorder. |
| 86363-CPT | Low | Test For Autoimmune Disorder, This Test Looks For Antibodies That Are Present In Myelin-Oligodendrocyte Glycoprotein Antibody-Associated Disease (Mogad) An Autoimmune Disorder. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86362. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86362 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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