CPT code 86001: Allergen IgG, each allergen2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Laboratories report 86001 for measurement of IgG antibodies to each allergen tested, distinguishing it from allergen-specific IgE testing.
Medicare pays $7.82 for 86001 under the 2026 Clinical Laboratory Fee Schedule: one national amount, the same in every state and setting.
Medicare lab fee · CLFS 2026 Q4
National CLFS amount
$7.82
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2020
- Unchanged
- CMS updates
- Quarterly
Medicare pays the lesser of the lab’s charge and this amount. Patients usually owe no Part B deductible or coinsurance for covered clinical lab tests.
On this page 7 sections
What 86001 covers
86001 identifies laboratory measurement of IgG antibodies directed against an allergen. The service is reported separately for each allergen tested; it is not an allergen-specific IgE measurement. The distinction is the antibody class measured: allergen-specific IgE codes describe measurement of IgE, including individual-allergen testing, multiple-allergen screening, and recombinant-component testing. Report 86001 for allergen-specific IgG measurement rather than selecting it based on an IgE assay’s allergen count or format.
Report one unit for each allergen measured. Medicare pays 86001 only through the CLFS. The 2026 national CLFS amount is $7.82 and has remained unchanged since 2020. One amount applies in every state and locality, with no geographic adjustment or office-versus-facility difference. The physician fee schedule excludes the test by statute.
This summary was written with AI assistance from CMS Clinical Laboratory Fee Schedule data. Amounts on this page come directly from CMS files.
How Medicare pays 86001
Clinical lab tests aren’t priced like physician services. They’re paid from their own fee schedule, with its own rules. See the whole lab fee schedule.
One national amount
CMS sets a single Clinical Laboratory Fee Schedule amount for 86001. There’s no geographic (GPCI) adjustment, so it pays the same in every state and payment locality.
No office or facility rate
Lab tests aren’t built from relative value units, so there’s no office and facility split: the place of service doesn’t change the CLFS amount.
Updated every quarter
CMS republishes the CLFS each quarter. New tests, often proprietary laboratory analyses (PLA codes), join during the year; existing amounts are updated each January.
Excluded from the physician fee schedule
The physician fee schedule lists 86001 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86001 on the lab fee schedule since 2020
86001 · CLFS 2026 Q4 (current)
$7.82
Unchanged since Jan 1, 2020
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
86001 compared with similar tests
- 86003Allergen IgECrude extract, each allergen$5.22
- Use 86001 for allergen-specific IgG measurement. Use 86003 when the laboratory measures IgE to an individual allergen.
- 86005IgE screenQualitative, multiple allergens$7.97
- 86001 measures IgG for each allergen tested; 86005 describes multiple-allergen IgE screening.
- 86008Allergen IgERecombinant or purified component$17.93
- 86001 measures allergen-specific IgG. 86008 measures IgE to a recombinant allergen component.
86001 billing questions
How is 86001 different from allergen-specific IgE testing?
86001 measures IgG antibodies to an allergen. Allergen-specific IgE codes measure IgE, so select the code that matches the antibody measured.
How many units should be reported?
Report one unit for each allergen measured.
Which codes describe allergen-specific IgE testing?
86003 describes IgE testing for an individual allergen, 86005 describes multiple-allergen IgE screening, and 86008 describes IgE testing for a recombinant allergen component.
Does Medicare pay 86001 under the physician fee schedule?
No. Medicare pays 86001 through the CLFS, with one amount across localities and settings.
Where this amount comes from
FeeBase reads lab amounts directly from the CMS Clinical Laboratory Fee Schedule file for the quarter: one row per code, with its payment indicator and national amount. Contractor-priced tests are labeled, never given a made-up amount. Amounts are Medicare payment limits, not a patient’s bill or a commercial rate.
CMS CLFS 2026 Q4 · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file line behind this amount
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