How much does Medicare pay for CPT 86645?

Medicare allowed an average of $16.47 per service and paid $16.47 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $116.59, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 86645?

Analysis for antibody (igm) to cytomegalovirus (cmv). It was billed 13,763 times to 12,521 Medicare beneficiaries by 85 providers in 2024.

Which specialty bills 86645 most?

Clinical Laboratory, with 13,574 services from 80 clinicians. Next are Rheumatology, Physician Assistant, Pathology.

CPT 86645

Analysis for antibody (igm) to cytomegalovirus (cmv)

$16.47Medicare-allowed amount per service, averaged across 13,763 services

Providers submitted

$116.59

Asking price, not received

Medicare allowed

$16.47

The fee schedule figure

Medicare paid

$16.47

Balance is patient coinsurance

Providers submitted an average of $116.59 for this code and Medicare allowed $16.47 — 7.1× 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 $16.47 (100%); the rest is the patient’s coinsurance and deductible.

Services: 13,763
Beneficiaries: 12,521
Providers billing it: 85
Total allowed: $226,677

What Medicare pays for CPT 86645

Across 13,763 services billed by 85 providers to 12,521 beneficiaries, Medicare allowed an average of $16.47 per service. 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 86645

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	13,574	12,352	$16.47	80
Rheumatology	86	72	$16.51	1
Physician Assistant	58	53	$16.51	1
Pathology	32	31	$16.51	2
Hematology-Oncology	13	13	$16.51	1

86645 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.

State	Services	Allowed	Standardized pmt	Providers
New Jersey	3,993	$16.50	$16.51	6
California	1,586	$16.49	$16.51	14
Florida	1,526	$16.43	$16.50	4
North Carolina	1,050	$16.51	$16.51	2
Texas	954	$16.49	$16.51	7
Arizona	893	$16.40	$16.51	3
New York	540	$16.51	$16.51	4
Minnesota	372	$16.37	$16.51	2
Ohio	352	$16.51	$16.51	4
Tennessee	290	$16.46	$16.51	2
Georgia	278	$16.51	$16.51	1
Massachusetts	251	$16.51	$16.51	2
Kansas	239	$16.51	$16.51	3
Alabama	224	$16.51	$16.51	1
Illinois	186	$16.51	$16.51	1
Pennsylvania	156	$16.51	$16.51	4
Washington	146	$16.49	$16.51	2
Wisconsin	118	$16.09	$16.51	2
Virginia	87	$16.04	$16.51	2
Maryland	71	$16.51	$16.51	1
Michigan	65	$16.51	$16.51	2
Oklahoma	64	$16.28	$16.51	3
Nevada	58	$16.51	$16.51	1
Hawaii	57	$16.51	$16.51	2
Colorado	46	$16.51	$16.51	1
Oregon	44	$16.51	$16.51	2
Utah	32	$16.06	$16.51	2
New Mexico	31	$16.51	$16.51	1
South Dakota	16	$16.51	$16.51	1
Nebraska	13	$16.51	$16.51	1
Rhode Island	13	$16.51	$16.51	1
Kentucky	12	$16.51	$16.51	1

Related codes

86618Analysis for antibody borrelia burgdorferi (lyme disease bacteria)$16.68
86617Confirmation test for antibody to borrelia burgdorferi (lyme disease b$15.17
86635Analysis for antibody to coccidioides (bacteria)$11.21
86666Analysis for antibody to ehrlichia (bacteria transmitted by ticks)$9.97
86665Analysis for antibody to epstein-barr virus (mononucleosis virus)$17.75
86609Analysis for antibody bacteria$12.54
86684Analysis for antibody to haemophilus influenza (respiratory bacteria)$15.52
86677Analysis for antibody to helicobacter pylori (gastrointestinal bacteri$16.50
86664Analysis for antibody to epstein-barr virus (mononucleosis virus)$14.96
86696Analysis for antibody to herpes simplex virus$18.92
86695Analysis for antibody to herpes simplex virus$12.91
86671Analysis for antibody to fungus$11.99

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.