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See a sample rate comparisonCPT 86720 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.
Bacteria Immunity Test, This Test Verifies Exposure To Leptospira Bacteria Which Are Transmitted By Animals. If Antibodies Are Present Immunity Is Likely.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 21 - Inpatient Hospital |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $16.20 national lab fee schedule rate (2026) · View Medicare rates for 86720 |
| Medicaid Fee Schedule | $14.905 median of the 8 states in the free preview · View Medicaid rates for 86720 |
National average reimbursement for CPT 86720 by major payers:
$13.37
$14.29
$17.19
$23.53
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CPT 86720
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$60.00Published ratePrisma Health-Upstate, Prisma Health Op Surgery Patewood
Prisma Health - Upstate
$14.57Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$13.34Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$7.97Published rateSt. Davids Healthcare Partnership, L.P., LLP, Heart Hospital Of Austin
Lone Star Circle Of Care
$6.80Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86720 vs. Other Immunology Procedures Codes
The CPT 86720 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 86720 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 |
|---|---|---|
| 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. |
| 86720-CPT | Low | Bacteria Immunity Test, This Test Verifies Exposure To Leptospira Bacteria Which Are Transmitted By Animals. If Antibodies Are Present Immunity Is Likely. |
| 86723-CPT | Low | Food Poisoning Immune Test, The Test Checks For Antibodies To Listeria Monocytogenes A Bacteria Commonly Responsible For Food Poisoning. |
| 86738-CPT | Low | Pneumonia Antibody Test, This Test Detects Antibodies To Mycoplasma Pneumoniae Bacteria Which Causes Pneumonia (Walking Pneumonia). Positive Results Indicate Current Or Past Infection. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86720. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86720 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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