CPT 86003

Across 2,483,466 services billed by 284 providers to 99,598 beneficiaries, Medicare allowed an average of $5.11 per service. That is 24.9 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

• 86038Screening test for autoimmune disorder$11.83
• 86039Measurement of antibody for assessment of autoimmune disorder$10.93
• 86037Antineutrophil cytoplasmic antibody titer$11.81
• 86008Measurement of antibody (ige) to allergic substance$17.54
• 86036Screening test for antineutrophil cytoplasmic antibody$11.80
• 86015Measurement of actin (smooth muscle) antibody$11.80
• 86021Antibody identification test for white blood cell antibodies$14.74
• 86001Measurement of antibody (igg) to allergic substance$6.19
• 86077Blood bank physician services for cross match and/or evaluation and wr$48.77
• 86060Measurement for strep antibody (strep throat)$7.15
• 86041Test for acetylcholine receptor binding antibody$17.97
• 86063Screening test for strep antibody (strep throat)$5.65

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

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