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See a sample rate comparisonCPT 86632 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.
Chlamydia Infection Evaluation, This Blood Test Evaluates The Likelihood Of Previous Or Current Exposure To Chlamydia. Chlamydia Are Bacteria That Can Cause Infections Of The Eyes Urinary Tract And Lungs.
| 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 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $12.68 national lab fee schedule rate (2026) · View Medicare rates for 86632 |
| Medicaid Fee Schedule | $11.665 median of the 8 states in the free preview · View Medicaid rates for 86632 |
National average reimbursement for CPT 86632 by major payers:
$11.53
$13.15
$14.05
$18.60
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CPT 86632
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$27.90Published rateEast Cooper Community Hospital, Inc., East Cooper Medical Center
$12.68Published ratePrisma Health-Upstate, Prisma Health Ob/Gyn Clinic
Prisma Health - Upstate
$11.40Published rateChristopher Raio
St Francis Hospital
$7.61Published 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
$4.44Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86632 vs. Other Immunology Procedures Codes
The CPT 86632 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 86632 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 |
|---|---|---|
| 86631-CPT | Low | Chlamydia Infection Evaluation, This Blood Test Evaluates The Likelihood Of Previous Or Current Exposure To Chlamydia. Chlamydia Are Bacteria That Can Cause Infections Of The Eyes Urinary Tract And Lungs. |
| 86632-CPT | Low | Chlamydia Infection Evaluation, This Blood Test Evaluates The Likelihood Of Previous Or Current Exposure To Chlamydia. Chlamydia Are Bacteria That Can Cause Infections Of The Eyes Urinary Tract And Lungs. |
| 86644-CPT | Low | Cytomegalovirus (Cmv) Test, The Test Checks For Antibody Response To Cytomegalovirus (Cmv). Results Can Indicate Either Current Or Previous Cmv Infection. |
| 86658-CPT | Low | Virus Antibody Blood Test, The Test Detects Antibodies To The Enterovirus Group. The Presence Of Antibodies In The Blood Indicates 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 86632. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86632 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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