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See a sample rate comparisonCPT 86641 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.
Fungal Infection Test, The Test Checks For Antibodies To Cryptococcus A Common Fungus Found In Soil. Positive Results Indicate Current Or Past Infection.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 21 - Inpatient Hospital 81 - Independent Laboratory |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $14.41 national lab fee schedule rate (2026) · View Medicare rates for 86641 |
| Medicaid Fee Schedule | $13.255 median of the 8 states in the free preview · View Medicaid rates for 86641 |
National average reimbursement for CPT 86641 by major payers:
$13.25
$14.21
$15.72
$21.36
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CPT 86641
5 of 25 sample ratesHigher to lower in this preview
St. Luke'S Community Health Services, St. Luke'S The Woodlands Hospital
St Lukes Community Health Services
$26.69Published ratePrisma Health-Upstate, Prisma Health Ctr For Ped & Int Med-West
Prisma Health - Upstate
$12.97Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$11.48Published rateGonzales Healthcare Systems
$8.46Published rateSt Davids Healthcare Partnership Lp LLP, Round Rock Medical Center
Lone Star Circle Of Care
$6.05Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86641 vs. Other Immunology Procedures Codes
The CPT 86641 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 86641 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. |
| 86635-CPT | Low | Valley Fever Antibody Test, Valley Fever Is Caused By The Fungus Coccidioides Immitis Which Is Common In Desert Areas. This Blood Test Detects Antibodies That Indicate A Current Or Past Infection. |
| 86641-CPT | Low | Fungal Infection Test, The Test Checks For Antibodies To Cryptococcus A Common Fungus Found In Soil. Positive Results Indicate Current Or Past Infection. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86641. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86641 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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