CPT code 86343: Histamine release, leukocyte assay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Laboratory testing of histamine release from leukocytes, reported when this cellular immune assay is performed.
Medicare pays $12.46 for 86343 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
$12.46
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 86343 covers
The assay measures histamine, an immune-system chemical, released by leukocytes (white blood cells). It evaluates a cellular response rather than directly measuring an antibody concentration. Report 86343 when the laboratory performs leukocyte histamine-release testing; it is distinct from leukocyte phagocytosis and lymphocyte transformation testing, which assess other cellular functions. The assay is reported to the ordering clinician as a laboratory result.
Medicare pays 86343 solely through the CLFS. CMS sets one national amount for all states and localities, with no geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $12.46, unchanged each year from 2020 through 2025. The test is excluded from the physician fee schedule by statute. Report the laboratory service under code 86343 when this assay is performed.
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 86343
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 86343. 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 86343 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86343 on the lab fee schedule since 2020
86343 · CLFS 2026 Q4 (current)
$12.46
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.
86343 compared with similar tests
- 86003Allergen IgECrude extract, each allergen$5.22
- Reports allergen-specific IgE measurement for an individual allergen; 86343 measures histamine release from leukocytes.
- 86344PhagocytosisWhite blood cell function$10.39
- Reports leukocyte phagocytosis, not histamine release. Choose according to the cellular function the laboratory measured.
- 86353Lymphocyte responseMitogen- or antigen-induced$49.03
- Reports a lymphocyte transformation assay, a different cellular immune test from leukocyte histamine release.
86343 billing questions
When should 86343 be selected instead of allergen-specific IgE testing?
Use 86343 when the test performed measures histamine release from leukocytes. Allergen-specific IgE testing measures a different response and is reported with its own code.
Is 86343 a physician-fee-schedule service?
No. Medicare pays this test through the CLFS; it is excluded from the physician fee schedule by statute.
Does 86343 describe an antibody measurement?
No. It describes measurement of histamine released from leukocytes, not measurement of allergen-specific antibody.
Does Medicare pay a different amount by locality or setting?
No. The CLFS amount is national and does not vary by state, locality, or office-versus-facility setting.
Should 86343 be reported for a leukocyte phagocytosis assay?
No. Leukocyte phagocytosis is a different laboratory assay; 86343 is for leukocyte histamine release.
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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