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See a sample rate comparisonCPT 86711 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.
Jc Virus Test, This Test Is Performed When Jc (John Cunningham) Virus Is Suspected. The Jc Virus Can Cause A Brain And Spinal Cord Infection Called Pml (Progressive Multifocal Leukoencephalopathy) In Individuals With Compromised Immune Systems.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $16.89 national lab fee schedule rate (2026) · View Medicare rates for 86711 |
| Medicaid Fee Schedule | $15.54 median of the 8 states in the free preview · View Medicaid rates for 86711 |
National average reimbursement for CPT 86711 by major payers:
$14.77
$10.78
$33.43
$44.01
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CPT 86711
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$37.16Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$22.29Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$14.56Published rateProgressive Emergency Physicians PLLC
$8.82Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$5.90Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86711 vs. Other Immunology Procedures Codes
The CPT 86711 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 86711 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 |
|---|---|---|
| 86711-CPT | Low | Jc Virus Test, This Test Is Performed When Jc (John Cunningham) Virus Is Suspected. The Jc Virus Can Cause A Brain And Spinal Cord Infection Called Pml (Progressive Multifocal Leukoencephalopathy) In Individuals With Compromised Immune Systems. |
| 86717-CPT | Low | Leishmania Antibody Test, The Test Checks For Antibodies To The Parasite Group Leishmania Which Cause Intestinal Upset. Antibodies Indicate A Past Or Current Infection. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86711. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86711 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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