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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 59 - Distinct Procedural Service 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | $13.19 national lab fee schedule rate (2026) · View Medicare rates for 86741 |
| Medicaid Fee Schedule | $12.135 median of the 8 states in the free preview · View Medicaid rates for 86741 |
National average reimbursement for CPT 86741 by major payers:

$12.03

$13.46

$16.92

$19.20
Choose a payer to see a sample of rates for CPT 86741.
Restorative Health Rehabilitation Inc
Christopher Raio
Good Samaritan Hosptial Medical Center
Prisma Health-Upstate, Prisma Health Op Surgery Spartanburg
Prisma Health - Upstate
El Campo Memorial Hospital
El Campo Memorial Hospital
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Rate Benchmarking
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See a sample payer proposalCPT 86741 vs. Other Immunology Procedures Codes
The CPT 86741 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 86741 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 |
|---|---|---|
| 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. |
| 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. |
| 86741-CPT | Low | Meningitis Antibody Test, The Test Detects Antibodies To Neisseria Meningitis The Bacteria That Causes Meningitis (Brain Swelling). The Presence Of Antibodies In Spinal Fluid Or Blood Indicates A Past Or Current Infection. |
| 86744-CPT | Low | Nocardia Bacteria Immune Test, The Test Identifies Antibodies To Nocardia Bacteria Which Creates Open Sores Or Lung Infections. Generally The Bacteria Infect Immune-Compromised People. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86741. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86741 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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