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See a sample rate comparisonHealthcare 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 | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $12.05 national lab fee schedule rate (2026) · View Medicare rates for 86704 |
| Medicaid Fee Schedule | $11.90 median of the 8 states in the free preview · View Medicaid rates for 86704 |
National average reimbursement for CPT 86704 by major payers:

$10.52

$8.57

$14.71

$17.63
Choose a payer to see a sample of rates for CPT 86704.
Celesta Hunsiker
Slocum Dickson Medical Group PLLC
Wade Hunt
Slocum Dickson Medical Group PLLC
Karen Flick
Slocum Dickson Medical Group PLLC
Sarah Rosario
Slocum Dickson Medical Group PLLC
Mohammad-Ali Yazdani Abyaneh
Slocum Dickson Medical Group PLLC
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Rate Benchmarking
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See a sample payer proposalCPT 86704 vs. Other Immunology Procedures Codes
The CPT 86704 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 86704 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 |
|---|---|---|
| 86704-CPT | Low | Hepatitis B Antibody Test, This Blood Test Detects Antibodies For Hepatitis B A Virus That Can Damage The Liver. Test Results Can Indicate A Current Chronic Or Past Infection. They Also Can Indicate Immunity From A Vaccination. |
| 86705-CPT | Low | Hepatitis B Antibody Test, This Blood Test Detects Antibodies For Hepatitis B A Virus That Can Damage The Liver. Test Results Can Indicate A Current Chronic Or Past Infection. They Also Can Indicate Immunity From A Vaccination. |
| 86706-CPT | Low | Hepatitis B Antibody Test, This Blood Test Detects Antibodies For Hepatitis B A Virus That Can Damage The Liver. Test Results Can Indicate A Current Chronic Or Past Infection. They Also Can Indicate Immunity From A Vaccination. |
| 86707-CPT | Low | Hepatitis B Antibody Test, This Blood Test Detects Antibodies For Hepatitis B A Virus That Can Damage The Liver. Test Results Can Indicate A Current Chronic Or Past Infection. They Also Can Indicate Immunity From A Vaccination. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86704. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86704 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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