CPT code 86381: Mitochondrial antibody, each antibody measured2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures mitochondrial antibodies, including M2, and is reported when clinicians evaluate suspected primary biliary cholangitis or related autoimmune liver disease.
Medicare pays $25.45 for 86381 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
$25.45
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 7 sections
What 86381 covers
This laboratory assay measures antibodies directed against mitochondrial targets, including M2. Clinicians commonly order it when evaluating suspected primary biliary cholangitis, especially with a cholestatic liver-test pattern, or as part of an autoimmune liver disease workup. Clinical laboratories perform the assay and report results to ordering clinicians, who interpret them alongside other clinical and laboratory findings.
Report the code for each mitochondrial antibody measured; “each” refers to the antibody target, not the number of specimens. Medicare pays the test under the CLFS only. The 2026 national CLFS amount is $25.45, the same amount listed for each year from 2022 through 2025. One national amount applies across states and localities, with no office-versus-facility difference for this code.
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 86381
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 86381. 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 86381 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86381 on the lab fee schedule since 2022
86381 · CLFS 2026 Q4 (current)
$25.45
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.
86381 compared with similar tests
- 86376Microsomal antibodyThyroid or liver-kidney$14.55
- This code measures microsomal antibodies, a different antibody target. Select the code that matches the antibody measured.
- 86340Intrinsic factor antibodyAutoimmune B12 evaluation$15.08
- This code measures intrinsic factor antibodies, used in evaluating a different autoimmune condition; it does not represent mitochondrial antibodies.
- 86341Islet cell antibodyPancreatic islet antibodies$23.57
- This code measures islet cell antibodies, associated with evaluation of autoimmune diabetes rather than mitochondrial antibody testing.
86381 billing questions
When should this code be selected instead of the microsomal antibody code?
Use this code for mitochondrial antibodies, such as M2, in an evaluation that may include primary biliary cholangitis. The microsomal antibody code is for a different antibody target.
Does “each” refer to each specimen?
No. “Each” refers to the mitochondrial antibody measured, not the number of specimens collected.
Is this test paid under the physician fee schedule?
No. Medicare pays this laboratory test through the CLFS.
Does payment vary by locality or office versus facility setting?
No. One national CLFS amount applies across localities, with no office-versus-facility difference.
Does this code include M2 antibody measurement?
Yes. M2 is an example of a mitochondrial antibody target measured under this code.
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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