CPT 86147

Across 255,555 services billed by 276 providers to 88,632 beneficiaries, Medicare allowed an average of $24.88 per service. That is 2.9 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.

• 86140Measurement c-reactive protein for detection of infection or inflammat$5.07
• 86160Measurement of complement (immune system proteins)$11.73
• 86141Measurement c-reactive protein for detection of infection or inflammat$12.67
• 86146Beta 2 glycoprotein 1 antibody (autoantibody) measurement$24.73
• 86162Measurement of complement (immune system proteins)$19.87
• 86148Phospholipid antibody (autoimmune antibody) measurement$15.71
• 86161Measurement of complement function (immune system proteins)$11.74
• 86157Measurement of cold agglutinin (protein) to detect infection or diseas$7.89

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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