How much does Medicare pay for CPT 86039?

Medicare allowed an average of $10.93 per service and paid $10.93 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $56.38, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 86039?

Measurement of antibody for assessment of autoimmune disorder, titer. It was billed 139,512 times to 125,233 Medicare beneficiaries by 213 providers in 2024.

Which specialty bills 86039 most?

Clinical Laboratory, with 132,483 services from 138 clinicians. Next are Rheumatology, Pathology, Internal Medicine.

CPT 86039

Measurement of antibody for assessment of autoimmune disorder, titer

$10.93Medicare-allowed amount per service, averaged across 139,512 services

Providers submitted

$56.38

Asking price, not received

Medicare allowed

$10.93

The fee schedule figure

Medicare paid

$10.93

Balance is patient coinsurance

Providers submitted an average of $56.38 for this code and Medicare allowed $10.93 — 5.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $10.93 (100%); the rest is the patient’s coinsurance and deductible.

Services: 139,512
Beneficiaries: 125,233
Providers billing it: 213
Total allowed: $1,524,866

What Medicare pays for CPT 86039

Across 139,512 services billed by 213 providers to 125,233 beneficiaries, Medicare allowed an average of $10.93 per service. 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.

Who bills 86039

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	132,483	119,578	$10.93	138
Rheumatology	5,404	4,157	$10.89	60
Pathology	1,240	1,122	$10.87	6
Internal Medicine	200	196	$10.80	4
Family Practice	92	90	$10.88	2
Hematology-Oncology	47	45	$10.94	1
Neurology	27	27	$10.94	1
Gastroenterology	19	18	$10.94	1

86039 reimbursement by state

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.

State	Services	Allowed	Standardized pmt	Providers
California	27,280	$10.93	$10.94	37
New Jersey	19,138	$10.93	$10.94	16
Florida	18,695	$10.93	$10.94	9
Texas	15,561	$10.93	$10.94	17
Georgia	11,251	$10.94	$10.94	1
New York	6,264	$10.93	$10.94	22
Illinois	5,755	$10.93	$10.94	8
Kansas	4,677	$10.94	$10.94	3
Massachusetts	3,802	$10.94	$10.94	5
Arizona	3,795	$10.88	$10.94	3
Pennsylvania	3,421	$10.92	$10.94	8
Nevada	2,654	$10.92	$10.94	2
Oklahoma	2,577	$10.91	$10.94	5
Tennessee	2,420	$10.91	$10.94	2
Minnesota	1,839	$10.89	$10.94	3
Maryland	1,734	$10.93	$10.94	2
Ohio	1,465	$10.90	$10.94	8
Virginia	1,256	$10.90	$10.94	4
Wisconsin	985	$10.79	$10.94	4
Alabama	742	$10.78	$10.94	9
Hawaii	640	$10.94	$10.94	1
Utah	610	$10.92	$10.94	3
New Mexico	400	$10.83	$10.94	1
Iowa	364	$10.91	$10.94	6
South Dakota	316	$10.86	$10.94	2
Indiana	312	$10.91	$10.94	3
South Carolina	305	$10.91	$10.94	4
Arkansas	175	$10.90	$10.94	5
North Carolina	174	$10.94	$10.94	5
Michigan	147	$10.80	$10.94	2
Kentucky	138	$10.79	$10.94	2
Idaho	126	$10.94	$10.94	1
Washington	97	$10.94	$10.94	1
Rhode Island	90	$10.94	$10.94	1
Maine	78	$10.81	$10.94	1
Colorado	72	$10.94	$10.94	2
Louisiana	64	$10.94	$10.94	1
Wyoming	41	$10.70	$10.94	1
Connecticut	23	$10.50	$10.94	1
Oregon	15	$10.94	$10.94	1
New Hampshire	14	$10.94	$10.94	1

Related codes

86003Measurement of antibody (ige) to allergic substance$5.11
86038Screening test for autoimmune disorder$11.83
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

Billing this code is not the same as earning it

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.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.