CPT code 86146: Beta-2 glycoprotein, each antibody class2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures autoantibodies to beta-2 glycoprotein I, typically as part of an antiphospholipid syndrome evaluation for thrombosis or pregnancy complications.
Medicare pays $25.45 for 86146 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
$25.45
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 8 sections
What 86146 covers
This laboratory assay measures autoantibodies directed against beta-2 glycoprotein I, a protein involved in phospholipid-related immune activity. Clinicians commonly order it when evaluating possible antiphospholipid syndrome, including in patients with unexplained thrombosis, recurrent pregnancy loss, or an associated autoimmune condition such as lupus. Testing is performed by a clinical laboratory, generally on a blood sample, and results are interpreted with the patient’s clinical history and other antiphospholipid tests.
The code’s “each” designation distinguishes antibody classes: report a separate unit for each class measured, such as IgG or IgM. This assay is often ordered alongside cardiolipin antibody testing and lupus anticoagulant studies, but those are separate tests. Medicare pays the test only through the CLFS. The 2026 national CLFS amount is $25.45, unchanged since 2020; one amount applies across localities, without geographic or office/facility variation.
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 86146
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 86146. 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 86146 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86146 on the lab fee schedule since 2020
86146 · CLFS 2026 Q4 (current)
$25.45
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.
86146 compared with similar tests
- 86147Cardiolipin antibodyEach immunoglobulin class$25.45
- Use 86146 for antibodies to beta-2 glycoprotein I; use 86147 for cardiolipin antibodies. They test different antibody targets.
- 86148Anti-phospholipid antibodyPhosphatidylserine antibody$16.07
- Code 86148 reports a separate antiphospholipid antibody assay. It is not a substitute for measuring beta-2 glycoprotein I antibodies.
- 85613Viper venom testDiluted clotting assay$9.58
- Code 85613 is a clot-based lupus anticoagulant study, whereas 86146 measures a specific autoantibody.
86146 billing questions
What does “each” mean for this code?
It refers to each antibody class measured. When separate classes such as IgG and IgM are tested, report each class separately.
How is this different from cardiolipin antibody testing?
This assay detects antibodies to beta-2 glycoprotein I. Code 86147 is for cardiolipin antibodies, a different target that may be evaluated in the same clinical workup.
Is lupus anticoagulant testing included?
No. Lupus anticoagulant studies assess clotting behavior and are separate from this antibody assay; they may be ordered as part of the same evaluation.
How does Medicare pay for this test?
Medicare pays it through the CLFS only. The national amount is the same across localities and does not vary by office or facility setting.
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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