CPT 86850

Across 38,926 services billed by 138 providers to 28,671 beneficiaries, Medicare allowed an average of $9.54 per service. That is 1.4 services per beneficiary, so this is a code patients typically receive more than once. 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.

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.

• 86803Hepatitis c antibody measurement$13.94
• 86800Thyroglobulin (thyroid protein) antibody measurement$15.57
• 86880Red blood cell antibody detection test$5.28
• 86832Assessment of antibody to human leukocyte antigens (hla)$301.77
• 86833Assessment of antibody to human leukocyte antigens (hla)$302.29
• 86812Immunologic analysis for autoimmune disease$25.27
• 86870Identification of red blood cell antibodies$85.79

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.

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