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See a sample rate comparisonCPT 86692 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.
Hepatitis D Antibody Test, This Blood Test Detects Antibodies For Hepatitis D A Virus That Can Damage The Liver. If The Result Is Positive There Is A Current Or Previous Infection.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $17.16 national lab fee schedule rate (2026) · View Medicare rates for 86692 |
| Medicaid Fee Schedule | $15.785 median of the 8 states in the free preview · View Medicaid rates for 86692 |
National average reimbursement for CPT 86692 by major payers:
$15.17
$16.26
$19.42
$24.99
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CPT 86692
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$40.00Published rateChristopher Raio
St Francis Hospital
$22.65Published rateAaron Askew
Praxis Health, P.C.
$18.88Published ratePrisma Health-Upstate
Prisma Health - Upstate
$15.43Published rateSt. Davids Healthcare Partnership, L.P., LLP, Heart Hospital Of Austin
Lone Star Circle Of Care
$7.21Published rate
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See a sample payer proposalCPT 86692 vs. Other Immunology Procedures Codes
The CPT 86692 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 86692 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. |
| 86692-CPT | Low | Hepatitis D Antibody Test, This Blood Test Detects Antibodies For Hepatitis D A Virus That Can Damage The Liver. If The Result Is Positive There Is A Current Or Previous Infection. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86692. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86692 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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