RxDoctor Payments Data

CPT 86341

Islet cell (pancreas) antibody measurement

$23.07Medicare-allowed amount per service, averaged across 43,490 services
Providers submitted
$235.68

Asking price, not received

Medicare allowed
$23.07

The fee schedule figure

Medicare paid
$23.07

Balance is patient coinsurance

Providers submitted an average of $235.68 for this code and Medicare allowed $23.0710.2× 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 $23.07 (100%); the rest is the patient’s coinsurance and deductible.

Services
43,490

Medicare Part B, 2024

Beneficiaries
26,465
Providers billing it
98
Total allowed
$1,003,314

Services × allowed amount

What Medicare pays for CPT 86341

Across 43,490 services billed by 98 providers to 26,465 beneficiaries, Medicare allowed an average of $23.07 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 86341

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory43,49026,465$23.0798

86341 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
North Carolina6,289$23.09$23.101
California5,930$23.09$23.1011
New Jersey5,644$23.10$23.104
Florida4,144$23.09$23.105
Texas3,616$23.09$23.107
New York1,913$23.09$23.107
Georgia1,800$23.10$23.102
Massachusetts1,720$22.81$23.104
Kansas1,498$23.10$23.103
Minnesota1,386$23.03$23.104
Arizona1,383$23.07$23.103
Alabama1,143$23.10$23.101
Illinois1,015$23.10$23.102
Ohio871$23.07$23.105
Nevada596$23.10$23.101
Tennessee552$23.06$23.103
Maryland550$23.07$23.103
Washington538$23.08$23.103
Pennsylvania469$23.10$23.104
Wisconsin454$22.84$23.102
Virginia440$23.10$23.105
Colorado426$23.10$23.102
Utah296$22.88$23.102
Oklahoma219$23.10$23.103
Oregon117$23.10$23.103
Hawaii111$22.93$23.102
Iowa102$22.90$23.101
Kentucky72$23.10$23.101
New Mexico62$23.10$23.101
Indiana58$23.10$23.101
Maine40$23.10$23.101
Rhode Island36$23.10$23.101

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.