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CPT 86618 Fee Schedule

Last Verified: March 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.

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
Medicare Fee ScheduleView Medicare rates for 86618

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$17.031417471467 - WEATHERFORD HEALTH SERVICES, LLC, MEDICAL CITY WEATHERFORD822073410 - (TX) WEATHERFORD HEALTH SERVICES LLCTXGeneral Acute Care Hospital (282N00000X)
United
86618$17.031851632616 - LANCASTER REGIONAL HOSPITAL, LP, CRESCENT MEDICAL CENTER LANCASTER273815440 - (TX) LANCASTER REGIONAL HOSPITAL, LPTXGeneral Acute Care Hospital (282N00000X)
United
86618$7.151104830900 - VAL VERDE HOSPITAL CORPORATION, VAL VERDE REGIONAL MEDICAL CENTER742941598 - VAL VERDE HOSPITAL CORPORATIONTXGeneral Acute Care Hospital (282N00000X)
United
86618$7.151649223645 - ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP, ROUND ROCK MEDICAL CENTER743001674 - (TX) LONE STAR CIRCLE OF CARETXGeneral Acute Care Hospital (282N00000X)
United
86618$9.731174526529 - TITUS COUNTY HOSPITAL DISTRICT, TITUS REGIONAL MEDICAL CENTER756003935TXGeneral Acute Care Hospital (282N00000X)
United
86618$17.031811942238 - KPH-CONSOLIDATION, INC., HCA HOUSTON HEALTHCARE NORTH CYPRESS A CAMPUS OF HCA HOUSTON HEALTHCAR621619857TXGeneral Acute Care Hospital (282N00000X)
United
86618$10.131013212448 - GUSTAVO DELGADO746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICTTXGeneral Acute Care Hospital (282N00000X)
United
86618$15.321043218365 - HOSPITAL SERVICE DISTRICT NO. 1 OF THE PARISH OF ST. MARY, BAYOU BEND HEALTH SYSTEM726008504 - (LA) HOSPITAL SERVICE DISTRICT NO 1 OF THE PARISH OF ST MARYLACritical Access Hospital (282NC0060X)
United
86618$23.791275633604 - EL PASO VAMC742934770TXGeneral Acute Care Hospital (282N00000X)
United
86618$14.471235685892 - FAIRFIELD HOSPITAL DISTRICT, FREESTONE MEDICAL CENTER741774669TXGeneral Acute Care Hospital (282N00000X)
United
86618$13.931851400485 - GEORGE HEMSTREET451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
86618$23.791922058569 - SAN ANTONIO VAMC742112082TXGeneral Acute Care Hospital (282N00000X)
United
86618$17.031740450121 - HOUSTON NORTHWEST OPERATING COMPANY, LLC, HOUSTON NORTHWEST MEDICAL CENTER ACUTE261512163TXGeneral Acute Care Hospital (282N00000X)
United
86618$17.031841843455 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE EMERGENCY ROOM MONTWOOD813935393 - (TX) HCN EP HORIZON CITY LLCTXGeneral Acute Care Hospital (282N00000X)
United
86618$17.031447230388 - OPELOUSAS GENERAL HOSPITAL AUTHORITY720708111LAGeneral 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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