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CPT 86652 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 Encephalitis Eastern Equin
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Immunology Procedures

Common Place of Service

81 - Independent Laboratory

21 - Inpatient Hospital

Common Modifiers

None

26 - Professional component

91 - Repeat Lab Test

Complexity LevelLow

National average reimbursement for CPT 86652 by major payers:

bcbs

$12.00

uhc

$14.19

aetna

$14.97

cigna

$19.61

Preview provider-level rates for...
For billing codeCPT 86652
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 86652

United
86652$13.181417471467 - WEATHERFORD HEALTH SERVICES, LLC, MEDICAL CITY WEATHERFORD822073410 - (TX) WEATHERFORD HEALTH SERVICES LLCTXGeneral Acute Care Hospital (282N00000X)
United
86652$5.531083903744 - HOSPITAL SERVICE DISTRICT OF THE PARISH OF ST. BERNARD, STATE OF LOUIS, ST. BERNARD PARISH HOSPITAL261576974 - (LA) HOSPITAL SERVICE DISTRICT OF THE PARISH OF ST BERNARD STATE OF LOUISLARural Acute Care Hospital (282NR1301X)
United
86652$25.381477516466 - SCOTT & WHITE MEMORIAL HOSPITAL, BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE742958277 - SCOTT & WHITE CLINICTXGeneral Acute Care Hospital (282N00000X)
United
86652$17.001588648315 - POINTE COUPEE PARISH HEALTH SERVICES DISTRICT NUMBER ONE, POINTE COUPEE GENERAL HOSPITAL721054801LACritical Access Hospital (282NC0060X)
United
86652$35.901124052162 - CITIZENS MEDICAL CENTER COUNTY OF VICTORIA, COUNTY OF VICTORIA CITIZENS MEDICAL CENTER741698143TXGeneral Acute Care Hospital (282N00000X)
United
86652$13.181720033947 - ST. DAVIDS HEALTHCARE PARTNERSHIP, L.P., LLP, HEART HOSPITAL OF AUSTIN742781812TXGeneral Acute Care Hospital (282N00000X)
United
86652$18.431033168786 - HOUSTON VAMC760418077TXGeneral Acute Care Hospital (282N00000X)
United
86652$15.821689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL752313255TXGeneral Acute Care Hospital (282N00000X)
United
86652$7.921316936990 - EL PASO COUNTY HOSPITAL DISTRICT, UNIVERSITY MEDICAL CENTER OF EL PASO752668018TXGeneral Acute Care Hospital (282N00000X)
United
86652$7.901619057155 - SABINE MEDICAL CENTER262074318LAGeneral Acute Care Hospital (282N00000X)
United
86652$13.181568461572 - WILLIS KNIGHTON MEDICAL CENTER, INC.720400933 - (LA) WILLIS-KNIGHTON MEDICAL CENTERLAGeneral Acute Care Hospital (282N00000X)
United
86652$18.431033168786 - HOUSTON VAMC760418077TXGeneral Acute Care Hospital (282N00000X)
United
86652$19.251225031495 - MONROE SURGICAL HOSPITAL, LLC721479756 - (LA) MONROE SURGICAL HOSPITALLAGeneral Acute Care Hospital (282N00000X)
United
86652$25.381477516466 - SCOTT & WHITE MEMORIAL HOSPITAL, BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE742958277 - SCOTT & WHITE CLINICTXGeneral Acute Care Hospital (282N00000X)
United
86652$13.181306897277 - COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP, MEDICAL CITY DENTON621682213 - (TX) COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LPTXGeneral 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 86652 vs. Other Immunology Procedures Codes

The CPT 86652 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 86652 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
86651-CPTLowAntibody Encephalitis California
86652-CPTLowAntibody Encephalitis Eastern Equin
86653-CPTLowAntibody Encephalitis St Louis
86654-CPTLowAntibody Encephalitis Western Equin

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86652. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 86652 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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