CPT code 86353: Lymphocyte response, mitogen- or antigen-induced2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures lymphocyte blastogenesis after mitogen or antigen stimulation, reported for testing of stimulated lymphocyte function.
Medicare pays $49.03 for 86353 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
$49.03
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 86353 covers
Code 86353 represents a laboratory measurement of white blood cell function based on lymphocyte blastogenesis induced by a mitogen or antigen. It captures a functional response to a selected stimulus, rather than the number of lymphocytes or a particular lymphocyte subset. The result reflects the stimulated transformation being tested; it is distinct from total B-cell, total T-cell, and T-cell count-and-ratio measurements reported under other codes.
Report 86353 for the lymphocyte transformation assay performed. Medicare pays this test only under the Clinical Laboratory Fee Schedule (CLFS), at one national amount applicable in every state and locality, without geographic or office-versus-facility adjustment. The 2026 national amount is $49.03, unchanged from 2020 through 2026. The test is excluded from the physician fee schedule and is paid through 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 86353
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 86353. 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 86353 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86353 on the lab fee schedule since 2020
86353 · CLFS 2026 Q4 (current)
$49.03
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.
86353 compared with similar tests
- 86352Cell function assayStimulated biomarker assay$135.86
- Choose 86353 for lymphocyte transformation after mitogen or antigen stimulation. Code 86352 describes a stimulated cell-function assay.
- 86359T-cell countTotal population$37.73
- Code 86359 reports a total T-cell count. Code 86353 measures stimulated lymphocyte blastogenesis.
- 86360T-cell countCD4, CD8, and ratio$46.98
- Code 86360 reports a T-cell count and ratio; 86353 measures lymphocyte transformation after stimulation.
- 86343Histamine releaseLeukocyte assay$12.46
- Code 86343 measures leukocyte histamine release. Code 86353 measures lymphocyte blastogenesis induced by a mitogen or antigen.
86353 billing questions
When should 86353 be selected over a lymphocyte count code?
Use 86353 for lymphocyte blastogenesis induced by a mitogen or antigen. Lymphocyte count codes report cell counts rather than this stimulated functional response.
How does 86353 differ from 86352?
Code 86353 describes lymphocyte transformation after mitogen or antigen stimulation. Code 86352 describes a stimulated cell-function assay.
Does 86353 report a lymphocyte population count?
No. It measures stimulated lymphocyte blastogenesis, not the number of lymphocytes or a lymphocyte subset.
How does Medicare pay for 86353?
Medicare pays 86353 under the CLFS only. The national amount applies 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
Fee sheets · Coming soon
Put 86353 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist