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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.
Tetanus Immunity Test, This Test Is Used Primarily To Determine Immune Status To Tetanus. It Is Rarely Used To Diagnose An Infection.
| 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 | $14.80 national lab fee schedule rate (2026) · View Medicare rates for 86774 |
| Medicaid Fee Schedule | $13.615 median of the 8 states in the free preview · View Medicaid rates for 86774 |
National average reimbursement for CPT 86774 by major payers:
$13.32
$14.61
$16.75
$21.70
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CPT 86774
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$40.00Published rateChristopher Raio
St Joseph Hospital
$19.54Published rateLaredo Texas Hospital Company Lp, Laredo Medical Center
$14.80Published rateChristopher Raio
Mercy Medical Center
$8.88Published rateEthicus Hospital Dfw LLC, Legent Orthopedic Hospital
Ethicus Hospital Dfw
$6.21Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86774 vs. Other Immunology Procedures Codes
The CPT 86774 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 86774 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 |
|---|---|---|
| 86771-CPT | Low | Shigella Antibody Test, The Test Detects Antibodies To Shigella Bacteria Which Cause Intestinal Illnesses. The Presence Of Antibodies Indicates Past Or Current Infection. |
| 86774-CPT | Low | Tetanus Immunity Test, This Test Is Used Primarily To Determine Immune Status To Tetanus. It Is Rarely Used To Diagnose An Infection. |
| 86777-CPT | Low | Toxoplasma Antibody Test, Toxoplasmosis Is An Illness Carried By A Parasite That Can Cause Complications With A Pregnancy. Immune-Compromised People Also Are At Risk. Testing Checks Spinal Fluid Blood Or Amniotic Fluid. The Result Shows A Current Or Past Infection Or Immunity. |
| 86780-CPT | Low | Syphilis Testing, This Test Detects Antibodies To Syphilis A Bacterial Infection. It Is Frequently Spread By Sexual Contact. Blood Tests Screen For The Infection And Monitor Response To Treatment. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86774. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86774 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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