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See a sample rate comparisonCPT 86830 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 Phenotype Qual, Antibody To Human Leukocyte Antigens Hla Solid Phase Assays Eg Microspheres Or Beads Elisa Flow Cytometry Antibody Identification By Qualitative Panel Using Complete Hla Phenotypes Hla Class I
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 81 - Independent Laboratory |
| Common Modifiers | PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $95.52 national lab fee schedule rate (2026) · View Medicare rates for 86830 |
| Medicaid Fee Schedule | $87.875 median of the 8 states in the free preview · View Medicaid rates for 86830 |
National average reimbursement for CPT 86830 by major payers:
$79.12
$61.80
$91.56
$154.58
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CPT 86830
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$210.14Published rateMaricopa County Special Health Care District, Valleywise Health
$114.62Published rateRolando Henriquez
Progressive Medical Center, S.C.
$61.04Published rateChristopher Raio
St Francis Hospital
$51.58Published 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
$33.43Published rate
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See a sample payer proposalCPT 86830 vs. Other Immunology Procedures Codes
The CPT 86830 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 86830 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 |
| 86830-CPT | Low | Hla Class I Phenotype Qual, Antibody To Human Leukocyte Antigens Hla Solid Phase Assays Eg Microspheres Or Beads Elisa Flow Cytometry Antibody Identification By Qualitative Panel Using Complete Hla Phenotypes Hla Class I |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86830. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86830 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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