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See a sample rate comparisonCPT 86615 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.
Whooping Cough Test, This Test Detects Antibodies To Bordetella Pertussis Bacteria Which Cause Whooping Cough. Positive Results Indicate Current Or Past Infection Or Immunity From A Vaccination. The Test Most Often Evaluates The Effectiveness Of A Vaccine.
| 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 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | $13.19 national lab fee schedule rate (2026) · View Medicare rates for 86615 |
| Medicaid Fee Schedule | $12.135 median of the 8 states in the free preview · View Medicaid rates for 86615 |
National average reimbursement for CPT 86615 by major payers:
$11.77
$13.52
$15.23
$19.35
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CPT 86615
5 of 25 sample ratesHigher to lower in this preview
All Ways Homecare Inc
$60.00Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$13.19Published rateWaccamaw Community Hospital, Tidelands Waccamaw Community Hospital
Waccamaw Community Hospital
$13.18Published rateNicole Schwab
Allergy & Asthma Of Dupage, S.C.
$10.55Published rateAmari Thomas
$5.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86615 vs. Other Immunology Procedures Codes
The CPT 86615 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 86615 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 |
|---|---|---|
| 86615-CPT | Low | Whooping Cough Test, This Test Detects Antibodies To Bordetella Pertussis Bacteria Which Cause Whooping Cough. Positive Results Indicate Current Or Past Infection Or Immunity From A Vaccination. The Test Most Often Evaluates The Effectiveness Of A Vaccine. |
| 86617-CPT | Low | Test For Lyme Disease, Lyme Disease Is Caused By Borrelia Burgdorferi And This Test Detects Antibodies Produced In Response. A Follow-Up Test Confirms A Positive Result. The Test Sample May Be Spinal Fluid Blood Or Urine. |
| 86618-CPT | Low | Test For Lyme Disease, Lyme Disease Is Caused By Borrelia Burgdorferi And This Test Detects Antibodies Produced In Response. A Follow-Up Test Confirms A Positive Result. The Test Sample May Be Spinal Fluid Blood Or Urine. |
| 86619-CPT | Low | Relapsing Fever Test, The Test Detects Antibodies To Borrelia Bacteria Which Cause Relapsing Fever. The Presence Of Antibodies Suggests A Past Or Current Infection. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86615. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86615 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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