RxDoctor Payments Data

CPT 86140

Measurement c-reactive protein for detection of infection or inflammation

$5.07Medicare-allowed amount per service, averaged across 2,334,614 services
Providers submitted
$56.13

Asking price, not received

Medicare allowed
$5.07

The fee schedule figure

Medicare paid
$5.07

Balance is patient coinsurance

Providers submitted an average of $56.13 for this code and Medicare allowed $5.0711.1× 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 $5.07 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility
$5.07
Hospital / facility
$5.08

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 2,334,161 services were billed in an office setting and 453 in a facility.

Services
2,334,614

Medicare Part B, 2024

Beneficiaries
1,467,281
Providers billing it
3,894
Total allowed
$11,836,493

Services × allowed amount

What Medicare pays for CPT 86140

Across 2,334,614 services billed by 3,894 providers to 1,467,281 beneficiaries, Medicare allowed an average of $5.07 per service. That is 1.6 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.

Who bills 86140

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory1,887,9591,202,893$5.07562
Rheumatology239,624119,454$5.04645
Internal Medicine60,07240,934$5.06855
Family Practice34,05926,858$5.05706
Pathology31,73923,530$5.0557
Nurse Practitioner27,01717,609$5.04367
Physician Assistant17,43412,353$5.04250
Hematology-Oncology11,7256,482$5.06105
Cardiology4,2441,770$5.0710
Gastroenterology3,8072,785$5.0575
Pain Management1,9981,695$5.0012
Endocrinology1,8801,442$5.0314
Infectious Disease1,8311,068$5.0332
Medical Oncology1,328692$5.0617
Pulmonary Disease1,148902$5.0717

86140 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.

StateServicesAllowedStandardized pmtProviders
California310,061$5.08$5.08167
New Jersey280,320$5.08$5.0861
Texas235,850$5.06$5.08245
Florida217,873$5.08$5.08222
North Carolina183,928$5.07$5.08229
Arizona94,975$5.07$5.0872
New York93,153$5.07$5.08217
Ohio81,604$5.07$5.0892
Alabama63,088$5.07$5.0882
Tennessee61,829$5.05$5.08309
Kansas58,440$5.08$5.0864
Georgia55,420$5.07$5.08134
Maryland54,698$5.07$5.08137
Washington52,666$5.06$5.0875
Illinois50,579$5.07$5.08112
Massachusetts48,677$5.08$5.08130
Oklahoma36,934$5.05$5.0865
Pennsylvania36,192$5.07$5.0835
Minnesota29,680$5.06$5.08171
Wisconsin24,230$5.00$5.0879
Colorado23,091$5.07$5.0826
Virginia22,519$5.07$5.0875
Nevada17,703$5.08$5.0813
Mississippi15,915$5.05$5.0847
Missouri15,142$5.05$5.0864
Iowa14,955$5.05$5.08127
Oregon14,822$5.06$5.0859
Arkansas14,387$5.03$5.08109
South Carolina14,348$5.06$5.0887
Louisiana14,120$5.06$5.0871
Hawaii10,885$5.05$5.085
Nebraska10,103$5.07$5.0868
Michigan9,962$5.07$5.0830
New Mexico9,838$5.06$5.0820
Indiana9,537$5.05$5.0845
Utah7,515$5.06$5.0858
Kentucky6,808$5.05$5.0834
Idaho5,377$5.02$5.0825
South Dakota4,566$5.07$5.0862
North Dakota3,715$5.06$5.0825
Maine3,308$5.07$5.0829
Rhode Island2,590$5.07$5.081
District of Columbia2,292$5.07$5.0811
Montana2,283$5.05$5.089
Puerto Rico2,083$5.06$5.0830
New Hampshire1,765$5.08$5.0822
Connecticut1,657$5.06$5.088
Alaska1,615$5.03$5.0817
Wyoming639$5.05$5.087
U.S. Virgin Islands409$5.08$5.083
West Virginia279$5.04$5.086
Delaware189$5.08$5.083

Related codes

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.