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CPT 86606

Analysis for antibody to aspergillus (fungus)

$14.64Medicare-allowed amount per service, averaged across 17,568 services
Providers submitted
$81.55

Asking price, not received

Medicare allowed
$14.64

The fee schedule figure

Medicare paid
$14.64

Balance is patient coinsurance

Providers submitted an average of $81.55 for this code and Medicare allowed $14.64 — 5.6× 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 $14.64 (100%); the rest is the patient’s coinsurance and deductible.

Services
17,568

Medicare Part B, 2024

Beneficiaries
11,717
Providers billing it
69
Total allowed
$257,196

Services × allowed amount

What Medicare pays for CPT 86606

Across 17,568 services billed by 69 providers to 11,717 beneficiaries, Medicare allowed an average of $14.64 per service. That is 1.5 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 86606

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory17,56811,717$14.6469

86606 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
California3,177$14.64$14.757
North Carolina3,096$14.74$14.751
New Jersey1,728$14.73$14.734
Texas1,621$14.63$14.756
New York1,085$14.38$14.752
Florida880$14.71$14.754
Arizona811$14.70$14.753
Georgia503$14.75$14.751
Kansas490$14.75$14.753
Nevada460$14.69$14.751
Utah381$14.73$14.752
Ohio353$13.92$14.754
Virginia296$13.47$14.753
Illinois277$14.75$14.751
Wisconsin254$14.75$14.751
Massachusetts237$14.75$14.752
Alabama227$14.75$14.751
Washington220$14.75$14.753
Tennessee213$14.69$14.753
Maryland169$14.75$14.751
Hawaii167$14.60$14.751
Pennsylvania163$14.75$14.752
Minnesota157$14.63$14.753
New Mexico154$14.58$14.751
Oklahoma130$14.75$14.753
Kentucky91$14.75$14.751
South Dakota83$14.75$14.751
Indiana82$14.26$14.751
Colorado47$14.75$14.752
Oregon16$14.75$14.751

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.