How much does Medicare pay for CPT 86664?

Medicare allowed an average of $14.96 per service and paid $14.96 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $98.93, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 86664?

Analysis for antibody to epstein-barr virus (mononucleosis virus), nuclear antigen. It was billed 29,334 times to 26,100 Medicare beneficiaries by 117 providers in 2024.

Which specialty bills 86664 most?

Clinical Laboratory, with 28,042 services from 106 clinicians. Next are Rheumatology, Physician Assistant, Pathology.

CPT 86664

Analysis for antibody to epstein-barr virus (mononucleosis virus), nuclear antigen

$14.96Medicare-allowed amount per service, averaged across 29,334 services

Providers submitted

$98.93

Asking price, not received

Medicare allowed

$14.96

The fee schedule figure

Medicare paid

$14.96

Balance is patient coinsurance

Providers submitted an average of $98.93 for this code and Medicare allowed $14.96 — 6.6× 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 $14.96 (100%); the rest is the patient’s coinsurance and deductible.

Services: 29,334
Beneficiaries: 26,100
Providers billing it: 117
Total allowed: $438,837

What Medicare pays for CPT 86664

Across 29,334 services billed by 117 providers to 26,100 beneficiaries, Medicare allowed an average of $14.96 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 86664

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	28,042	24,930	$14.96	106
Rheumatology	1,132	1,020	$14.98	7
Physician Assistant	58	53	$14.98	1
Pathology	54	53	$14.98	2
Family Practice	48	44	$14.98	1

86664 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	7,477	$14.97	$14.98	8
California	2,919	$14.96	$14.98	14
New York	2,897	$14.98	$14.98	12
Florida	2,808	$14.94	$14.97	5
North Carolina	2,440	$14.96	$14.98	5
Texas	2,254	$14.98	$14.98	9
Arizona	1,366	$14.96	$14.98	3
Ohio	970	$14.93	$14.98	7
Georgia	764	$14.98	$14.98	1
Massachusetts	630	$14.96	$14.98	3
Alabama	628	$14.95	$14.98	4
Kansas	611	$14.98	$14.98	4
Tennessee	611	$14.93	$14.98	3
Illinois	606	$14.98	$14.98	1
Washington	359	$14.98	$14.98	2
Pennsylvania	347	$14.98	$14.98	5
Maryland	305	$14.98	$14.98	3
Oklahoma	230	$14.83	$14.98	3
Nevada	162	$14.98	$14.98	1
Minnesota	147	$14.67	$14.98	3
Colorado	142	$14.98	$14.98	1
Oregon	117	$14.60	$14.98	3
Hawaii	113	$14.98	$14.98	2
Virginia	83	$14.70	$14.98	2
Utah	78	$14.81	$14.98	3
Kentucky	64	$14.98	$14.98	2
New Mexico	57	$14.98	$14.98	1
Rhode Island	42	$14.98	$14.98	1
Louisiana	41	$14.98	$14.98	2
Nebraska	18	$14.29	$14.98	1
Wisconsin	18	$14.21	$14.98	1
Michigan	16	$14.98	$14.98	1
North Dakota	14	$14.98	$14.98	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
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
86606Analysis for antibody to aspergillus (fungus)$14.64

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.