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See a sample rate comparisonCPT 86666 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $10.18 national lab fee schedule rate (2026) · View Medicare rates for 86666 |
| Medicaid Fee Schedule | $9.55 median of the 8 states in the free preview · View Medicaid rates for 86666 |
National average reimbursement for CPT 86666 by major payers:
$9.13
$7.34
$11.94
$15.09
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CPT 86666
5 of 25 sample ratesHigher to lower in this preview
Citizens Medical Center County Of Victoria, County Of Victoria Citizens Medical Center
$20.36Published rateWilbarger County Hospital District, Wilbarger General Hospital
Wilbarger General Hospital Employee Benefit Plan
$12.22Published rateAmisub Of South Carolina, Inc., Piedmont Medical Center
Amisub Of South Carolina Inc
$10.18Published rateKell West Regional Hospital LLC
Kell West Regional Hospital, LLC
$5.82Published ratePark Place Surgery Center, LLC, Park Place Surgical Hospital
Park Place Surgical Hospital
$3.66Published rate
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See a sample payer proposalCPT 86666 vs. Other Immunology Procedures Codes
The CPT 86666 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 86666 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 86666. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86666 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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