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See a sample rate comparisonCPT 86703 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | 26 - Professional component 92 - Alternative Lab Platform |
| Complexity Level | Low |
| Medicare Fee Schedule | $13.71 national lab fee schedule rate (2026) · View Medicare rates for 86703 |
| Medicaid Fee Schedule | $12.615 median of the 8 states in the free preview · View Medicaid rates for 86703 |
National average reimbursement for CPT 86703 by major payers:
$12.20
$13.88
$16.35
$20.16
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CPT 86703
5 of 25 sample ratesHigher to lower in this preview
Overlook Hospital
Atlantic Health System Inc
$20.36Published rateRohin Mehta
Slocum Dickson Medical Group PLLC
$11.39Published rateJohn Sullivan
Slocum Dickson Medical Group PLLC
$11.39Published rateAshley Parmentier
Slocum Dickson Medical Group PLLC
$5.76Published rateNiranjan Selvarajah
Slocum Dickson Medical Group PLLC
$5.76Published rate
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See a sample payer proposalCPT 86703 vs. Other Immunology Procedures Codes
The CPT 86703 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 86703 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. |
| 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. |
| 86702-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. |
| 86703-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 86703. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86703 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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