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See a sample rate comparisonCPT 86784 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.
Trichinella Antibody Test, The Test Detects Antibodies To The Roundworm Trichinella. The Parasite Can Be Picked Up From Undercooked Pork Or Bear Meat.
| 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 26 - Professional component PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | $12.56 national lab fee schedule rate (2026) · View Medicare rates for 86784 |
| Medicaid Fee Schedule | $11.555 median of the 8 states in the free preview · View Medicaid rates for 86784 |
National average reimbursement for CPT 86784 by major payers:
$11.33
$12.83
$13.84
$18.35
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CPT 86784
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$60.00Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Faris
Prisma Health - Upstate
$11.30Published rateChristopher Raio
St Joseph Hospital
$7.97Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$7.54Published 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
$4.40Published rate
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See a sample payer proposalCPT 86784 vs. Other Immunology Procedures Codes
The CPT 86784 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 86784 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 |
|---|---|---|
| 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. |
| 86778-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. |
| 86784-CPT | Low | Trichinella Antibody Test, The Test Detects Antibodies To The Roundworm Trichinella. The Parasite Can Be Picked Up From Undercooked Pork Or Bear Meat. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86784. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86784 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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