CPT 86665 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Pathology and Laboratory Procedures • Immunology Procedures |
| Common Place of Service | • 81 - Independent Laboratory • 11 - Office |
| Common Modifiers | • None • 91 - Repeat Lab Test • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 86665 |
National average reimbursement for CPT 86665 by major payers:

$15.81

$16.78

$20.77

$26.84
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 86665 | ||||||
United | 86665 | $18.13 | 1598744856 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST MEDICAL CENTER | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 86665 | $21.77 | 1689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL | 752313255 | TX | General Acute Care Hospital (282N00000X) |
United | 86665 | $18.13 | 1639422504 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL SCHERTZ | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 86665 | $18.13 | 1538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 86665 | $10.64 | 1457358103 - BELLVILLE HOSPITAL DISTRICT, BELLVILLE GENERAL HOSPITAL | 274005511 - BELLVILLE MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 86665 | $21.77 | 1609971019 - SCURRY COUNTY HOSPITAL DISTRICT, COGDELL MEMORIAL HOSPITAL | 752403687 - (TX) SCURRY COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 86665 | $10.38 | 1407191984 - BSA HOSPITAL LLC | 900914340 | TX | General Acute Care Hospital (282N00000X) |
United | 86665 | $18.13 | 1396520862 - LAKE SURGICAL HOSPITAL SLIDELL, LLC | 474228147 - (LA) LAKE SURGICAL HOSPITAL SLIDELL, LLC DBA SOUTHERN SURGICAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 86665 | $36.27 | 1124052162 - CITIZENS MEDICAL CENTER COUNTY OF VICTORIA, COUNTY OF VICTORIA CITIZENS MEDICAL CENTER | 741698143 | TX | General Acute Care Hospital (282N00000X) |
United | 86665 | $18.13 | 1003344334 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE HORIZON CITY CAMPUS | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 86665 | $18.13 | 1750819025 - NORTH HOUSTON, HCA HOUSTON HEALTHCARE TOMBALL | 821349955 | TX | General Acute Care Hospital (282N00000X) |
United | 86665 | $18.13 | 1598766495 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER,INC | 720423635 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | 86665 | $10.88 | 1295736734 - CHRISTUS HEALTH ARK-LA-TEX, CHRISTUS ST. MICHAEL HEALTH SYSTEM | 752616977 - CHRISTUS TRINITY CLINIC | TX | General Acute Care Hospital (282N00000X) |
United | 86665 | $25.35 | 1275633604 - EL PASO VAMC | 742934770 | TX | General Acute Care Hospital (282N00000X) |
United | 86665 | $14.82 | 1851400485 - GEORGE HEMSTREET | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 86665 vs. Other Immunology Procedures Codes
The CPT 86665 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 86665 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86665. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86665 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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