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See a sample rate comparisonCPT 86688 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 T-Cell Leukemia, This Blood Test Detects Infection With Human T-Cell Leukemia Ii Virus. It Also Is Used To Screen Blood And Blood Products Prior To Transfusion.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $14.00 national lab fee schedule rate (2026) · View Medicare rates for 86688 |
| Medicaid Fee Schedule | $13.825 median of the 8 states in the free preview · View Medicaid rates for 86688 |
National average reimbursement for CPT 86688 by major payers:
$12.67
$10.97
$16.03
$20.35
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CPT 86688
5 of 25 sample ratesHigher to lower in this preview
Da Pediatric Rehabilitation
$60.00Published rateChristopher Raio
St Joseph Hospital
$16.63Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$14.00Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Greer
Prisma Health - Upstate
$12.60Published rateDonna Medical Clonic
Donna Medical Clinic, P.A.
$5.88Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86688 vs. Other Immunology Procedures Codes
The CPT 86688 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 86688 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 |
|---|---|---|
| 86687-CPT | Low | Test For T-Cell Leukemia, This Blood Test Detects Infection With Human T-Cell Leukemia I Virus. It Also Is Used To Screen Blood And Blood Products Prior To Transfusion. |
| 86688-CPT | Low | Test For T-Cell Leukemia, This Blood Test Detects Infection With Human T-Cell Leukemia Ii Virus. It Also Is Used To Screen Blood And Blood Products Prior To Transfusion. |
| 86689-CPT | Low | Test To Confirm Hiv/Leukemia, This Test Is Used As A Confirmation Test When Initial Test Results Are Positive Or Inconclusive. The Test Verifies Either Human T-Cell Leukemia Ii Virus Or Hiv. |
| 86701-CPT | Low | Hiv Screening Test, This Test Detects Antibodies To Hiv (Aids Virus) Type 1 Type 2 Or Both. It Is Used To Screen For Hiv Infection. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86688. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86688 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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