CPT 86671 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 90 - Reference Laboratory 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 86671 |
| Medicaid Fee Schedule | View Medicaid rates for 86671 |
National average reimbursement for CPT 86671 by major payers:
$10.86
$12.78
$14.22
$17.93
CPT 86671 vs. Other Immunology Procedures Codes
The CPT 86671 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 86671 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 |
|---|---|---|
| 86625-CPT | Low | Campylobacter Lab Test, The Test Checks For Antibodies To Campylobacter A Bacteria Responsible For Intestinal Infections. A Positive Result Indicates Current Or Past Infection. |
| 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. |
| 86671-CPT | Low | Antibody Fungus Not Elsewhere Speci |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86671. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86671 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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