CPT code 86364: Tissue transglutaminase, each immunoglobulin class2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures antibodies to tissue transglutaminase by immunoglobulin class, commonly as part of serologic evaluation and monitoring for celiac disease.
Medicare pays $11.53 for 86364 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
$11.53
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2022
- 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 86364 covers
This serologic test measures antibodies directed against tissue transglutaminase. It is commonly ordered during evaluation for celiac disease and may be used to follow antibody levels during management. IgA and IgG are distinct classes; IgA testing is commonly used, while IgG testing can be useful when IgA deficiency affects interpretation. Primary care clinicians and gastroenterologists commonly order the test, with results produced by clinical or hospital laboratories.
Report the test once for each immunoglobulin class measured, rather than counting the concentration or number of specimens as separate units. Medicare pays it through the CLFS; the 2026 national amount is $11.53 and has been unchanged from 2022 through 2026. The same CLFS amount applies across localities, without an office or facility difference. The test is paid only through the CLFS, with no separate physician fee schedule payment.
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 86364
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 86364. 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 86364 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86364 on the lab fee schedule since 2022
86364 · CLFS 2026 Q4 (current)
$11.53
Unchanged since Jan 1, 2022
20 quarterly CLFS releases on file, first CLFS 2022 Q1. A code missing from a quarter wasn’t on that release.
86364 compared with similar tests
- 86231Endomysial antibodyEach immunoglobulin class$12.09
- This code measures tissue transglutaminase antibodies; 86231 is for endomysial antibody testing. They assess different celiac-associated antibodies.
- 82784ImmunoglobulinsIgA, IgD, IgG, or IgM$9.30
- This code measures antibodies directed against tissue transglutaminase by immunoglobulin class. Code 82784 measures the quantity of an immunoglobulin, such as total IgA.
- 83516ImmunoassayMultiple-step, qualitative or semiquantitative$11.53
- Use 86364 for the analyte-specific tissue transglutaminase test. Code 83516 describes an immunoassay for an analyte without a more specific code; it is not a substitute for 86364 for this test.
86364 billing questions
When should this code be chosen instead of an endomysial antibody test?
Use this code for measurement of tissue transglutaminase antibodies. Endomysial antibody testing measures a different celiac-associated antibody and is reported with its own code.
How are units determined?
Report once for each immunoglobulin class measured. Do not count antibody concentration as additional units.
Should total IgA be coded as the same test?
No. Total IgA measures the amount of immunoglobulin, not tissue transglutaminase antibodies. It may be ordered separately to help assess IgA status when interpreting an IgA-class result.
Is there a separate physician interpretation payment?
Medicare pays this test through the CLFS only. It has no separate physician fee schedule payment.
What documentation supports reporting this test?
Document the clinical reason for celiac serology and the immunoglobulin class or classes tested. The laboratory result should identify the class measured.
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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