CPT 86703 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 | • 11 - Office • 81 - Independent Laboratory |
| Common Modifiers | • None • 26 - Professional component • 92 - Alternative Lab Platform |
| Complexity Level | Low |
National average reimbursement for CPT 86703 by major payers:

$12.20

$13.88

$16.35

$20.58
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 86703 | ||||||
United | 86703 | $5.76 | 1982313656 - GABRIELLA PLADOCOSTANTE | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Medical Physician Assistant (363AM0700X) |
United | 86703 | $11.39 | 1063106441 - ANDREA MOEHRINGER | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 86703 | $5.76 | 1417944638 - JAMEEL ARASTU | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Neurology Physician (2084N0400X) |
United | 86703 | $15.77 | 1134887185 - SARAH ROSARIO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Medical Physician Assistant (363AM0700X) |
United | 86703 | $8.90 | 1871162834 - AHS HOSPITAL CORP, AHS CONSOLIDATED LABS | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Clinical Medical Laboratory (291U00000X) |
United | 86703 | $15.77 | 1851546659 - TRACY JAYNE | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Medical Physician Assistant (363AM0700X) |
United | 86703 | $5.76 | 1841577509 - ANNA COLLINS | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 86703 | $11.39 | 1588758403 - STEPHANIE HIGBY | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Physician Assistant (363A00000X) |
United | 86703 | $5.76 | 1649289430 - MARCY GAMBINO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Medical Physician Assistant (363AM0700X) |
United | 86703 | $11.39 | 1093081358 - KENNETH VISALLI | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Internal Medicine Physician (207R00000X) |
United | 86703 | $11.39 | 1770577884 - THOMAS JOHN | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Internal Medicine Physician (207R00000X) |
United | 86703 | $5.76 | 1174360945 - ASHLEY FAHY | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 86703 | $15.77 | 1699242115 - JEREMY SKIECHS | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Physician Assistant (363A00000X) |
United | 86703 | $5.76 | 1093316879 - CARLY ZEGARELLI | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Physical Therapist (225100000X) |
United | 86703 | $7.92 | 1255503686 - KIMBERLY HURLEY | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 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.
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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