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CPT 86590 Fee Schedule

Last Verified: November 2025

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.

Streptokinase, Antibody
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Immunology Procedures

Common Place of Service

11 - Office

50 - Federally Qualified Health Center

Common Modifiers

None

QW - CLIA Waived Tests

59 - Distinct Procedural Service

Complexity LevelLow

National average reimbursement for CPT 86590 by major payers:

bcbs

$11.00

uhc

$8.12

aetna

$12.65

cigna

$18.63

Preview provider-level rates for...
For billing codeCPT 86590
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 86590

United
86590$5.321790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
86590$5.321679845531 - DANA HEMSTREET451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALFamily Nurse Practitioner (363LF0000X)
United
86590$12.651982604021 - GEORGETOWN MEMORIAL HOSPITAL, TIDELANDS GEORGETOWN MEMORIAL HOSPITAL570341194 - GEORGETOWN MEMORIAL HOSPITALSCGeneral Acute Care Hospital (282N00000X)
United
86590$12.651689628984 - COLUMBIA HOSPITAL AT MEDICAL CITY DALLAS SUBSIDIARY LP, MEDICAL CITY DALLAS621682198TXGeneral Acute Care Hospital (282N00000X)
United
86590$5.321750474516 - NORTHWEST TEXAS SURGICAL HOSPITAL, LLC, NORTHWEST TEXAS SURGERY CENTER233086987 - (TX) NORTHWEST TEXAS SURGICAL HOSPITAL LLCTXGeneral Acute Care Hospital (282N00000X)
United
86590$13.971669480323 - KELL WEST REGIONAL HOSPITAL LLC752756307 - KELL WEST REGIONAL HOSPITAL, LLCTXGeneral Acute Care Hospital (282N00000X)
United
86590$12.651811942238 - KPH-CONSOLIDATION, INC., HCA HOUSTON HEALTHCARE NORTH CYPRESS A CAMPUS OF HCA HOUSTON HEALTHCAR621619857TXGeneral Acute Care Hospital (282N00000X)
United
86590$12.651255384533 - COLUMBIA MEDICAL CENTER OF LEWISVILLE SUBSIDIARY LP, MEDICAL CITY LEWISVILLE621682210 - (TX) DE MARKETING AND SALESTXGeneral Acute Care Hospital (282N00000X)
United
86590$12.651184911877 - VHS BROWNSVILLE HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE452663071TXGeneral Acute Care Hospital (282N00000X)
United
86590$24.371477516466 - SCOTT & WHITE MEMORIAL HOSPITAL, BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE742958277 - SCOTT & WHITE CLINICTXGeneral Acute Care Hospital (282N00000X)
United
86590$12.651689629941 - METHODIST HOSPITALS OF DALLAS, METHODIST MANSFIELD MEDICAL CENTER750800661 - METHODIST HOSPITALS OF DALLASTXGeneral Acute Care Hospital (282N00000X)
United
86590$21.041255478004 - CHRISTOPHER RAIO111635088 - MERCY MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
86590$7.601255478004 - CHRISTOPHER RAIO111635088 - MERCY MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
86590$7.601255478004 - CHRISTOPHER RAIO112050523 - ST FRANCIS HOSPITALNYEmergency Medicine Physician (207P00000X)
United
86590$27.851073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 86590 vs. Other Immunology Procedures Codes

The CPT 86590 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 86590 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
86580-CPTLowSkin Test; Tuberculosis,Intradermal
86590-CPTLowStreptokinase, Antibody
86592-CPTLowSyphilis Test, Non-Treponemal Antibody; Qualitative (Eg, Vdrl, Rpr, Art)
86593-CPTLowSyphilis Test, Non-Treponemal Antibody; Quantitative (Eg, Vdrl, Rpr, Art)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86590. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 86590 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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