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CPT 86618 Fee Schedule

Last Verified: December 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.

Antibody Borellia Bufgdorferi
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Immunology Procedures

Common Place of Service

81 - Independent Laboratory

11 - Office

Common Modifiers

None

59 - Distinct Procedural Service

90 - Reference Laboratory

Complexity LevelLow

National average reimbursement for CPT 86618 by major payers:

bcbs

$15.59

uhc

$13.32

aetna

$19.98

cigna

$25.48

Preview provider-level rates for...
For billing codeCPT 86618
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 86618

United
86618$13.931851400485 - GEORGE HEMSTREET451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
86618$12.671346611829 - AMARI THOMAS300520570 - (TX) METHODIST HOSPITALTXGeneral Acute Care Hospital (282N00000X)
United
86618$10.001356320873 - EAST TEXAS MEDICAL CENTER ATHENS751854562 - (TX) ETX SUCCESSOR ATHENSTXGeneral Acute Care Hospital (282N00000X)
United
86618$15.321104873710 - CLHG-OAKDALE, LLC, OAKDALE COMMUNITY HOSPITAL813465783 - (LA) CLHGOAKDALE LLCLAGeneral Acute Care Hospital (282N00000X)
United
86618$17.031538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS954537720TXGeneral Acute Care Hospital (282N00000X)
United
86618$10.131689663007 - THE GOOD SHEPHERD HOSPITAL, INC., CHRISTUS GOOD SHEPHERD MEDICAL CENTER - LONGVIEW751041154 - (TX) GOOD SHEPHERD HOSPITAL INCTXGeneral Acute Care Hospital (282N00000X)
United
86618$17.031598744856 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST MEDICAL CENTER760714523TXGeneral Acute Care Hospital (282N00000X)
United
86618$17.031487271375 - METHODIST HOSPITALS OF DALLAS, METHODIST MIDLOTHIAN MEDICAL CENTER750800661 - METHODIST HOSPITALS OF DALLASTXGeneral Acute Care Hospital (282N00000X)
United
86618$7.151740273994 - ECTOR COUNTY HOSPITAL DISTRICT, MEDICAL CENTER HOSPITAL752302928TXGeneral Acute Care Hospital (282N00000X)
United
86618$17.031740450121 - HOUSTON NORTHWEST OPERATING COMPANY, LLC, HOUSTON NORTHWEST MEDICAL CENTER ACUTE261512163TXGeneral Acute Care Hospital (282N00000X)
United
86618$23.791225087794 - AMARILLO VAMC751616212TXGeneral Acute Care Hospital (282N00000X)
United
86618$10.001356320873 - EAST TEXAS MEDICAL CENTER ATHENS751854562 - (TX) ETX SUCCESSOR ATHENSTXGeneral Acute Care Hospital (282N00000X)
United
86618$10.001972590602 - PALO PINTO COUNTY HOSPITAL DISTRICT, PALO PINTO GENERAL HOSPITAL751256948TXGeneral Acute Care Hospital (282N00000X)
United
86618$9.731508199621 - SERGE LARTCHENKO M.D., PLLC270839735 - (TX) SERGE LARTCHENKO MD PLLCTXGeneral Acute Care Hospital (282N00000X)
United
86618$23.791558314948 - DALLAS VAMC, BONHAM VAMC756108647TXGeneral Acute Care Hospital (282N00000X)
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 86618 vs. Other Immunology Procedures Codes

The CPT 86618 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 86618 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
86617-CPTLowBorrelia Burgdorferi (Lyme Disease) Confirmatory Test
86618-CPTLowAntibody Borellia Bufgdorferi
86619-CPTLowAntibody Borrelia (Relapsing Fever)
86638-CPTLowAntibody Coxiella Brunetii

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86618. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 86618 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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