RxDoctor Payments Data

CPT 86682

Analysis for antibody to helminth (intestinal worm)

$12.73Medicare-allowed amount per service, averaged across 3,448 services
Providers submitted
$179.66

Asking price, not received

Medicare allowed
$12.73

The fee schedule figure

Medicare paid
$12.73

Balance is patient coinsurance

Providers submitted an average of $179.66 for this code and Medicare allowed $12.7314.1× 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 $12.73 (100%); the rest is the patient’s coinsurance and deductible.

Services
3,448

Medicare Part B, 2024

Beneficiaries
3,119
Providers billing it
47
Total allowed
$43,893

Services × allowed amount

What Medicare pays for CPT 86682

Across 3,448 services billed by 47 providers to 3,119 beneficiaries, Medicare allowed an average of $12.73 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 86682

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory3,4483,119$12.7347

86682 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
New Jersey647$12.75$12.753
North Carolina557$12.75$12.751
California492$12.75$12.757
Minnesota322$12.63$12.752
Florida321$12.75$12.754
New York244$12.72$12.752
Texas177$12.75$12.755
Arizona119$12.75$12.753
Massachusetts77$12.75$12.752
Ohio77$12.58$12.752
Georgia63$12.75$12.751
Hawaii56$12.70$12.752
Alabama50$12.75$12.751
Utah39$12.75$12.751
Illinois33$12.75$12.751
Washington26$12.75$12.751
Maryland21$12.75$12.751
Kansas20$12.75$12.751
Wisconsin20$12.75$12.751
Virginia18$12.75$12.751
Nevada17$12.75$12.751
Colorado15$12.75$12.751
Tennessee14$12.75$12.751
Pennsylvania12$12.75$12.751
Oklahoma11$12.75$12.751

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.