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See a sample rate comparisonCPT 86828 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.
Hla Class I Ii Antibody Qual, Antibody To Human Leukocyte Antigens Hla Solid Phase Assays Eg Microspheres Or Beads Elisa Flow Cytometry Qualitative Assessment Of The Presence Or Absence Of Antibody Ies To Hla Class I And Class Ii Hla Antigens
| 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 | 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $64.19 national lab fee schedule rate (2026) · View Medicare rates for 86828 |
| Medicaid Fee Schedule | $59.055 median of the 8 states in the free preview · View Medicaid rates for 86828 |
National average reimbursement for CPT 86828 by major payers:
$51.43
$35.59
$60.91
$108.95
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CPT 86828
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$141.22Published rateAshley O'Connor
Atlantic Health System Inc
$65.47Published rateMichael Shuler
Athens Orthopedic Clinic, P.A.
$38.51Published rateAaron Askew
The Orthopedic And Neurosurgical Center Of The Cascades
$26.96Published rateSunrise Home Health Care Inc.
Sunrise Home Health Care Inc
$21.76Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86828 vs. Other Immunology Procedures Codes
The CPT 86828 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 86828 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 |
|---|---|---|
| 86825-CPT | Low | Blood Hla Crossmatch, Hla (Human Leukocyte Antigen) Crossmatching Is A Test Done To Ensure The Body Does Not Reject A Blood Transfusion Or Transplant. |
| 86826-CPT | Low | Hla X Match Noncytotoxc Addl, Human Leukocyte Antigen Hla Crossmatch Non Cytotoxic Eg Using Flow Cytometry Each Additional Serum Sample Or Sample Dilution List Separately In Addition To Primary Procedure |
| 86828-CPT | Low | Hla Class I Ii Antibody Qual, Antibody To Human Leukocyte Antigens Hla Solid Phase Assays Eg Microspheres Or Beads Elisa Flow Cytometry Qualitative Assessment Of The Presence Or Absence Of Antibody Ies To Hla Class I And Class Ii Hla Antigens |
| 86829-CPT | Low | Hla Class I Ii Antibody Qual, Antibody To Human Leukocyte Antigens Hla Solid Phase Assays Eg Microspheres Or Beads Elisa Flow Cytometry Qualitative Assessment Of The Presence Or Absence Of Antibody Ies To Hla Class I Or Class Ii Hla Antigens |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86828. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86828 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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