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CPT 86780 Fee Schedule

Last Verified: December 2025

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.

Antibody Treponema Pallidum
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Immunology Procedures

Common Place of Service

81 - Independent Laboratory

11 - Office

Common Modifiers

None

26 - Professional component

90 - Reference Laboratory

Complexity LevelLow

National average reimbursement for CPT 86780 by major payers:

bcbs

$11.76

uhc

$9.29

aetna

$15.46

cigna

$47.69

Preview provider-level rates for...
For billing codeCPT 86780
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 86780

United
86780$13.231639422504 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL SCHERTZ452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLCTXGeneral Acute Care Hospital (282N00000X)
United
86780$13.231205189172 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL OVERLOOK452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLCTXGeneral Acute Care Hospital (282N00000X)
United
86780$24.511710314141 - ST. LUKES HOSPITAL AT THE VINTAGE263734606 - (TX) ST LUKES HOSPITAL AT THE VINTAGETXGeneral Acute Care Hospital (282N00000X)
United
86780$13.231649223645 - ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP, ROUND ROCK MEDICAL CENTER742781812TXGeneral Acute Care Hospital (282N00000X)
United
86780$13.231306865761 - HOSPITAL SERVICE DISTRICT NO. 1 OF CALDWELL PARISH, CITIZENS MEDICAL CENTER720862035 - (LA) CITIZENS MEDICAL CENTERLAGeneral Acute Care Hospital (282N00000X)
United
86780$13.231154618742 - VHS HARLINGEN HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER452662980TXGeneral Acute Care Hospital (282N00000X)
United
86780$11.921205833241 - CLHG-WINN, LLC, WINN PARISH MEDICAL CENTER813465517LAGeneral Acute Care Hospital (282N00000X)
United
86780$13.231427472463 - RESOLUTE HOSPITAL COMPANY, LLC, RESOLUTE HEALTH HOSPITAL462942963 - (TX) RESOLUTE HOSPITAL COMPANY LLCTXGeneral Acute Care Hospital (282N00000X)
United
86780$13.231184911877 - VHS BROWNSVILLE HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE452663071TXGeneral Acute Care Hospital (282N00000X)
United
86780$11.381609135904 - ANDREW CORONA273026151 - (TX) MID COAST MEDICAL CENTER-CENTRALTXGeneral Acute Care Hospital (282N00000X)
United
86780$22.761972517365 - COVENANT MEDICAL CENTER822913146 - (TX) COVENANT MEDICAL CENTERTXGeneral Acute Care Hospital (282N00000X)
United
86780$7.961316936990 - EL PASO COUNTY HOSPITAL DISTRICT, UNIVERSITY MEDICAL CENTER OF EL PASO752668018TXGeneral Acute Care Hospital (282N00000X)
United
86780$13.231396129201 - UNION MEDICAL CENTER, UNION MEDICAL CENTER474491361SCGeneral Acute Care Hospital (282N00000X)
United
86780$7.571851390967 - UHS OF TEXOMA, INC, TEXOMA MEDICAL CENTER205908627 - UHS OF TEXOMA INCTXGeneral Acute Care Hospital (282N00000X)
United
86780$18.961922058569 - SAN ANTONIO VAMC742112082TXGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 86780 vs. Other Immunology Procedures Codes

The CPT 86780 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 86780 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.

CodeComplexityDescription
86774-CPTLowAntibody Tetanus
86777-CPTLowAntibody Toxoplasma
86778-CPTLowAntibody Toxoplasma Igm
86780-CPTLowAntibody Treponema Pallidum

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86780. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 86780 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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