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CPT 86703

Analysis for antibody to hiv-1 and hiv-2 virus

$13.43Medicare-allowed amount per service, averaged across 3,075 services
Providers submitted
$89.29

Asking price, not received

Medicare allowed
$13.43

The fee schedule figure

Medicare paid
$13.43

Balance is patient coinsurance

Providers submitted an average of $89.29 for this code and Medicare allowed $13.43 — 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 $13.43 (100%); the rest is the patient’s coinsurance and deductible.

Services
3,075

Medicare Part B, 2024

Beneficiaries
2,911
Providers billing it
34
Total allowed
$41,297

Services × allowed amount

What Medicare pays for CPT 86703

Across 3,075 services billed by 34 providers to 2,911 beneficiaries, Medicare allowed an average of $13.43 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 86703

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory2,9362,779$13.4326
Obstetrics & Gynecology5750$13.442
Hematology-Oncology5656$13.444
Physical Medicine and Rehabilitation1515$13.441
Family Practice1111$13.441

86703 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 York1,656$13.43$13.445
California754$13.44$13.446
Florida129$13.44$13.443
Kentucky108$13.44$13.441
Louisiana99$13.44$13.442
Texas96$13.31$13.443
Colorado46$13.44$13.442
South Carolina30$13.44$13.442
Pennsylvania28$13.44$13.442
Illinois26$13.44$13.441
New Jersey24$13.44$13.441
Mississippi15$13.44$13.441
Puerto Rico14$13.44$13.441
U.S. Virgin Islands14$13.44$13.441
Idaho13$13.44$13.441
Iowa12$13.44$13.441
Washington11$13.44$13.441

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.