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See a sample rate comparisonCPT 86602 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.
Bacterial Immunity Test, This Test Verifies Exposure To Actinomycetes A Gram-Positive Bacterium That Forms Thin Thread-Like Strands. When Antibodies Are Present There Is Some Immunity To Infection.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $10.18 national lab fee schedule rate (2026) · View Medicare rates for 86602 |
| Medicaid Fee Schedule | $9.55 median of the 8 states in the free preview · View Medicaid rates for 86602 |
National average reimbursement for CPT 86602 by major payers:
$9.22
$11.33
$11.46
$13.26
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CPT 86602
5 of 25 sample ratesHigher to lower in this preview
All Ways Homecare Inc
$60.00Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$12.09Published ratePrisma Health-Upstate, Prisma Health Center For Pediatric Med
Prisma Health - Upstate
$9.15Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$5.86Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$3.55Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86602 vs. Other Immunology Procedures Codes
The CPT 86602 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 86602 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 |
|---|---|---|
| 86580-CPT | Low | Tuberculosis (Tb) Skin Test, Tuberculosis (Tb) Skin Tests Check For Exposure. A Small Amount Of Tuberculin Protein Or Live Tuberculosis Is Injected Just Under The Skin Of The Lower Arm. The Test Site Is Examined 48 To 72 Hours Later To Check For A Reaction. |
| 86590-CPT | Low | Streptokinase Blood Test, A Blood Test For Streptokinase Antibodies Follows An Injection Given For A Blood Clot. The Number Of Antibodies That Develop Helps To Determine Both The Reaction To The Drug And Whether More Doses Can Be Given. |
| 86592-CPT | Low | Syphilis Testing, This Test Detects Antibodies To Syphilis A Bacterial Infection. It Is Frequently Spread By Sexual Contact. Blood Tests Screen For The Infection And Monitor Response To Treatment. |
| 86602-CPT | Low | Bacterial Immunity Test, This Test Verifies Exposure To Actinomycetes A Gram-Positive Bacterium That Forms Thin Thread-Like Strands. When Antibodies Are Present There Is Some Immunity To Infection. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86602. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86602 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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