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See a sample rate comparisonHealthcare 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.
| 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 TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $322.96 national lab fee schedule rate (2026) · View Medicare rates for 86835 |
| Medicaid Fee Schedule | $301.72 median of the 8 states in the free preview · View Medicaid rates for 86835 |
National average reimbursement for CPT 86835 by major payers:

$272.25

$228.40

$326.60

$480.60
Choose a payer to see a sample of rates for CPT 86835.
Matthew Lilley
Bend Memorial Clinic, PC
Christopher Raio
Good Samaritan Hosptial Medical Center
Aaron Askew
Praxis Health, P.C.
Baptist Health Care, Inc., Baptist Home Healt Care And Medical Equipment
Baptist Health Care Inc
Rouzbeh Afsari
Renal Consultants Medical Group
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Rate Benchmarking
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See a sample payer proposalCPT 86835 vs. Other Immunology Procedures Codes
The CPT 86835 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 86835 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 |
|---|---|---|
| 86833-CPT | Moderate | Hla Class Ii High Defin Qual, Antibody To Human Leukocyte Antigens Hla Solid Phase Assays Eg Microspheres Or Beads Elisa Flow Cytometry High Definition Qualitative Panel For Identification Of Antibody Specificities Eg Individual Antigen Per Bead Methodology Hla Class Ii |
| 86834-CPT | Moderate | Test For Hla Antibodies, This Blood Test Measures The Presence Or Absence Of Antibodies To Hla (Human Leukocyte Antigens). The Test Is Done To Ensure The Body Does Not Reject A Blood Transfusion Or Transplant. |
| 86835-CPT | Moderate | Test For Hla Antibodies, This Blood Test Measures The Presence Or Absence Of Antibodies To Hla (Human Leukocyte Antigens). The Test Is Done To Ensure The Body Does Not Reject A Blood Transfusion Or Transplant. |
| 86849-CPT | Moderate | Testing Related To Immunity, Testing That Involves The Immune System Function: Its Ability Action Of Particular Components Or The Presence Of Specific Infection-Targeted Responders. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86835. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86835 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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