Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 86664 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.
Mononucleosis Test, This Test Detects Current Or Prior Infection With The Epstein-Barr Virus Which Causes Infectious Mononucleosis And Is Associated With Certain Cancers.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $15.29 national lab fee schedule rate (2026) · View Medicare rates for 86664 |
| Medicaid Fee Schedule | $14.07 median of the 8 states in the free preview · View Medicaid rates for 86664 |
National average reimbursement for CPT 86664 by major payers:
$13.48
$15.02
$17.69
$22.27
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 86664.
CPT 86664
5 of 25 sample ratesHigher to lower in this preview
St Lukes Community Development Corporation, St Lukes Sugar Land Hospital
St Lukes Community Development Corporation-Sugar Land
$28.31Published rateHcn Ep Horizon City, LLC, The Hospitals Of Providence Emergency Room Montwood
Hcn Ep Horizon City LLC
$15.28Published rateWillis Knighton Medical Center, Inc., Willis Knighton South Hospital
Willis-Knighton Medical Center
$15.28Published rateEl Paso County Hospital District, University Medical Center Of El Paso
El Paso County Hospital District
$9.10Published rateDonna Medical Clonic
Donna Medical Clinic, P.A.
$6.42Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 86664 vs. Other Immunology Procedures Codes
The CPT 86664 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 86664 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 |
|---|---|---|
| 86663-CPT | Low | Mononucleosis Test, This Test Detects Current Or Prior Infection With The Epstein-Barr Virus Which Causes Infectious Mononucleosis And Is Associated With Certain Cancers. |
| 86664-CPT | Low | Mononucleosis Test, This Test Detects Current Or Prior Infection With The Epstein-Barr Virus Which Causes Infectious Mononucleosis And Is Associated With Certain Cancers. |
| 86665-CPT | Low | Mononucleosis Test, This Test Detects Current Or Prior Infection With The Epstein-Barr Virus Which Causes Infectious Mononucleosis And Is Associated With Certain Cancers. |
| 86666-CPT | Low | Test For Tick Fever, This Blood Test Checks For Antibodies Responding To A Current Or Past Infection Of Ehrlichia Chaffeensis Which Is A Bacteria Carried By Ticks That Causes An Illness Similar To Rocky Mountain Spotted Fever. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86664. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86664 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 86664) and we'll show you how you compare in 15 minutes or less.