CPT 86357

Across 16,548 services billed by 66 providers to 12,021 beneficiaries, Medicare allowed an average of $36.93 per service. That is 1.4 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.

• 86334Immunologic analysis technique on serum (immunofixation)$19.86
• 86376Microsomal antibodies (autoantibody) measurement$14.24
• 86300Immunologic analysis for detection of tumor antigen$20.21
• 86364Measurement of tissue transglutaminase$11.29
• 86317Detection of infectious agent antibody$14.63
• 86335Immunologic analysis technique on body fluid$24.16
• 86304Immunologic analysis for detection of tumor antigen$20.36
• 86301Immunologic analysis for detection of tumor antigen$20.37
• 86381Measurement of mitochondrial antibody$24.88
• 86360T cell count and ratio$45.96
• 86341Islet cell (pancreas) antibody measurement$23.07
• 86316Analysis for detection of tumor marker$20.36

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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