CPT code 86593: Syphilis test, quantitative antibody test2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports quantitative nontreponemal syphilis serology, commonly used to establish or follow antibody titers during syphilis evaluation and treatment.
Medicare pays $4.40 for 86593 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
$4.40
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 86593 covers
This laboratory assay measures nontreponemal antibodies associated with syphilis and reports a quantitative result, commonly as a titer. Clinicians order it during diagnostic evaluation and to assess serologic response over time, including after treatment. Clinical laboratories typically perform the test on serum. Clinicians may compare serial titers when evaluating changes in serologic activity.
Report 86593 when the laboratory performs and reports the quantitative nontreponemal assay; use the qualitative code when only a qualitative result is produced. The 2026 national CLFS amount is $4.40, unchanged since 2020. Medicare pays one amount per code nationwide, with no locality or office-versus-facility adjustment. The test is paid only through the CLFS, not the physician fee schedule.
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 86593
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 86593. 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 86593 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86593 on the lab fee schedule since 2020
86593 · CLFS 2026 Q4 (current)
$4.40
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.
86593 compared with similar tests
- 86592Syphilis testQualitative, nontreponemal$4.27
- Choose 86592 for a qualitative nontreponemal result; choose 86593 when the laboratory reports a quantitative result such as a titer.
- 86780Syphilis antibodyTreponemal antibody$13.24
- 86780 measures treponemal antibodies, while 86593 measures nontreponemal antibodies quantitatively. The tests assess different antibody responses.
86593 billing questions
How does 86593 differ from 86592?
86593 describes a quantitative nontreponemal result, commonly a titer. Use 86592 when the laboratory reports a qualitative result.
When is a quantitative result useful?
It can help assess syphilis serology during diagnostic evaluation and track antibody titers over time, including response to treatment.
Should the code be counted by titer or dilution?
Report the quantitative assay, not each dilution step used to determine the endpoint titer.
Does Medicare pay differently in an office and a facility?
No. Medicare pays one national CLFS amount for this code, without a locality or office-versus-facility adjustment.
How does this differ from treponemal antibody testing?
86593 measures nontreponemal antibodies quantitatively. Treponemal antibody tests assess antibodies directed against Treponema pallidum.
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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