How much does Medicare pay for CPT 86706?

Medicare allowed an average of $10.51 per service and paid $10.51 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $78.16, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 86706?

Hepatitis b surface antibody measurement. It was billed 179,628 times to 171,068 Medicare beneficiaries by 592 providers in 2024.

Does 86706 pay differently in an office than a hospital?

Yes. The allowed amount averaged $10.51 in an office setting and $10.53 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 86706 most?

Clinical Laboratory, with 169,306 services from 240 clinicians. Next are Internal Medicine, Family Practice, Nurse Practitioner.

CPT 86706

Hepatitis b surface antibody measurement

$10.51Medicare-allowed amount per service, averaged across 179,628 services

Providers submitted

$78.16

Asking price, not received

Medicare allowed

$10.51

The fee schedule figure

Medicare paid

$10.51

Balance is patient coinsurance

Providers submitted an average of $78.16 for this code and Medicare allowed $10.51 — 7.4× 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 $10.51 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $10.51
Hospital / facility: $10.53

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 179,602 services were billed in an office setting and 26 in a facility.

Services: 179,628
Beneficiaries: 171,068
Providers billing it: 592
Total allowed: $1,887,890

What Medicare pays for CPT 86706

Across 179,628 services billed by 592 providers to 171,068 beneficiaries, Medicare allowed an average of $10.51 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 86706

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	169,306	160,859	$10.51	240
Internal Medicine	3,610	3,587	$10.52	119
Family Practice	1,560	1,548	$10.52	41
Nurse Practitioner	1,245	1,237	$10.52	53
Rheumatology	1,214	1,199	$10.46	34
Physician Assistant	791	785	$10.49	31
Hematology-Oncology	701	672	$10.47	32
Pathology	673	665	$10.44	15
Medical Oncology	232	226	$10.41	10
Nephrology	69	65	$10.53	4
General Practice	62	62	$10.53	3
Obstetrics & Gynecology	60	59	$10.53	3
Geriatric Medicine	25	25	$10.53	1
Gastroenterology	24	23	$10.53	2
Infectious Disease	24	24	$10.53	2

86706 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
California	34,716	$10.51	$10.53	53
New Jersey	28,136	$10.52	$10.53	22
Texas	20,496	$10.52	$10.53	34
North Carolina	17,677	$10.52	$10.53	11
Florida	14,096	$10.49	$10.53	21
Massachusetts	7,903	$10.53	$10.53	205
Illinois	7,874	$10.53	$10.53	14
Arizona	4,832	$10.51	$10.53	5
Alabama	4,796	$10.51	$10.53	4
Ohio	4,651	$10.50	$10.53	11
New York	4,607	$10.52	$10.53	38
Georgia	3,737	$10.53	$10.53	3
Washington	3,472	$10.50	$10.51	18
Kansas	3,184	$10.53	$10.53	3
Pennsylvania	2,949	$10.51	$10.53	15
Oklahoma	2,551	$10.50	$10.53	30
Maryland	2,123	$10.51	$10.53	7
Nevada	1,938	$10.51	$10.53	3
Minnesota	1,747	$10.45	$10.53	6
Colorado	1,388	$10.49	$10.53	3
Oregon	1,072	$10.48	$10.53	6
Michigan	1,035	$10.52	$10.53	24
Virginia	974	$10.52	$10.53	5
Tennessee	850	$10.48	$10.53	4
Hawaii	562	$10.36	$10.53	2
South Carolina	372	$10.41	$10.53	4
Wisconsin	346	$9.72	$10.53	7
Kentucky	226	$10.48	$10.53	1
South Dakota	201	$10.53	$10.53	2
New Mexico	194	$10.49	$10.53	1
Utah	132	$10.39	$10.53	2
Connecticut	115	$10.53	$10.53	2
Iowa	111	$10.38	$10.53	5
Louisiana	95	$10.43	$10.53	3
Nebraska	84	$10.53	$10.53	1
Mississippi	65	$10.12	$10.53	3
North Dakota	61	$10.46	$10.53	3
Delaware	58	$10.53	$10.53	2
Missouri	35	$10.53	$10.53	1
Maine	33	$10.53	$10.53	1
Rhode Island	32	$10.23	$10.53	2
New Hampshire	31	$10.53	$10.53	1
Puerto Rico	29	$9.95	$10.53	1
Idaho	15	$10.53	$10.53	1
West Virginia	15	$10.53	$10.53	1
Indiana	12	$10.53	$10.53	1

Related codes

86704Hepatitis b core antibody measurement$11.79
86708Measurement of hepatitis a antibody$12.13
86769Measure of severe acute respiratory syndrome coronavirus 2 (covid-19)$41.06
86753Analysis for antibody to protozoa (parasite)$12.14
86705Hepatitis b core antibody (igm) measurement$11.52
86780Analysis for antibody$12.96
86709Measurement of hepatitis a antibody (igm)$11.02
86757Analysis for antibody to rickettsia (bacteria)$18.93
86787Analysis for antibody to varicella-zoster virus (chicken pox)$12.59
86738Analysis for antibody to mycoplasma (bacteria)$12.93
86762Analysis for antibody to rubella (german measles virus)$14.07
86765Analysis for antibody to rubeola (measles virus)$12.59

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.