CPT code 86352: Cell function assay, stimulated biomarker assay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This laboratory assay evaluates cell function after stimulation and detects a biomarker, distinguishing it from immune-cell count testing.
Medicare pays $135.86 for 86352 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
$135.86
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 86352 covers
The laboratory analysis concerns cell function and genetic markers. In the stimulated assay, cells are exposed to a mitogen or antigen and a resulting biomarker, such as ATP, is detected. This evaluates cell function rather than simply counting immune-cell populations. Laboratories perform and report the test as a cell-function assay.
Report 86352 for the stimulated cell-function assay. Medicare pays the test only through the CLFS, at one national amount that applies across states and localities without an office-versus-facility difference. The 2026 national CLFS amount is $135.86, unchanged from 2020 through 2026. The code is excluded from the physician fee schedule and is paid only under the CLFS.
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 86352
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 86352. 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 86352 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86352 on the lab fee schedule since 2020
86352 · CLFS 2026 Q4 (current)
$135.86
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.
86352 compared with similar tests
- 86353Lymphocyte responseMitogen- or antigen-induced$49.03
- 86352 describes a stimulated cell-function assay that detects a biomarker. 86353 describes lymphocyte transformation testing.
- 86360T-cell countCD4, CD8, and ratio$46.98
- 86360 reports a T-cell count and ratio, while 86352 reports a stimulated cell-function assay.
- 86343Histamine releaseLeukocyte assay$12.46
- 86343 describes leukocyte histamine-release testing; 86352 describes a stimulated cell-function assay with biomarker detection.
- 86344PhagocytosisWhite blood cell function$10.39
- 86344 describes leukocyte phagocytosis testing; 86352 describes a stimulated cell-function assay with biomarker detection.
86352 billing questions
How does 86352 differ from 86353?
86352 describes a stimulated cell-function assay that detects a biomarker response. 86353 describes lymphocyte transformation testing; select the code that matches the assay performed.
Does 86352 report a cell count?
No. It reports a stimulated cell-function assay, not a count of T cells or another immune-cell population.
Does Medicare pay 86352 under the physician fee schedule?
No. Medicare pays 86352 only through the CLFS.
How does Medicare price 86352?
Medicare pays one national CLFS amount across states and localities, with no office-versus-facility payment difference.
How does 86352 differ from leukocyte histamine-release or phagocytosis testing?
86343 describes leukocyte histamine-release testing, and 86344 describes leukocyte phagocytosis testing. Report the code that matches the assay performed.
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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