CPT code 86360: T-cell count, CD4, CD8, and ratio2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports absolute CD4 and CD8 T-cell counts and their ratio, commonly used to assess immune status and monitor people with HIV.
Medicare pays $46.98 for 86360 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
$46.98
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 86360 covers
This laboratory test measures absolute CD4 and CD8 T-cell counts and reports their ratio. Clinical laboratories commonly use flow cytometry on a blood specimen to enumerate these lymphocyte subsets. Clinicians order the test to assess immune status, particularly when monitoring HIV, and in other evaluations where the balance of CD4 and CD8 cells is relevant.
Report the test when both absolute counts and the ratio are performed; a total T-cell count or a CD4 count alone is a different service. Medicare pays this code through the CLFS. The 2026 national CLFS amount is $46.98, unchanged from 2020 through 2026. One national amount applies in every state and locality, without geographic adjustment or a difference between office and facility settings. The test is paid only 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 86360
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 86360. 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 86360 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86360 on the lab fee schedule since 2020
86360 · CLFS 2026 Q4 (current)
$46.98
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.
86360 compared with similar tests
- 86361CD4 countAbsolute count only$26.78
- This code includes absolute CD4 and CD8 counts and their ratio. Code 86361 is used when the reported service is an absolute CD4 count alone.
- 86359T-cell countTotal population$37.73
- Code 86359 reports total T cells. This code reports CD4 and CD8 subsets and their ratio.
- 86353Lymphocyte responseMitogen- or antigen-induced$49.03
- Code 86353 is a lymphocyte transformation test that evaluates cellular response. This code enumerates absolute CD4 and CD8 T-cell counts and reports their ratio.
86360 billing questions
When should this code be chosen instead of a total T-cell count?
Use this code when the laboratory reports absolute CD4 and CD8 counts and their ratio. A total T-cell count does not provide those subset results.
How does this differ from a CD4-only count?
This code represents both absolute CD4 and CD8 counts, including the ratio. Choose the CD4-only service when only an absolute CD4 count is performed.
What specimen is typically tested?
A blood specimen is commonly used for flow-cytometric enumeration of CD4 and CD8 T-cell subsets.
How does Medicare pay for this test?
Medicare pays it through the CLFS at one national amount, with the same amount across localities and office and facility settings. It is paid only through the CLFS.
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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