CPT code 86611: Bartonella antibody2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Bartonella antibody testing supports evaluation of suspected Bartonella infection, including cat-scratch disease in patients with compatible symptoms and exposure.
Medicare pays $10.18 for 86611 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
$10.18
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 86611 covers
This laboratory test analyzes a patient sample for antibodies to Bartonella bacteria. Clinicians may order it when evaluating suspected Bartonella infection, including cat-scratch disease, often in a patient with compatible regional lymph node enlargement after cat exposure. Other suspected Bartonella infections may also prompt testing. Clinical laboratories perform and report the antibody analysis for hospitals, clinics, and other ordering providers.
Report 86611 for the Bartonella antibody service performed; the code identifies the organism target, not a particular antibody method or isotype. Medicare pays the test through the CLFS, not the physician fee schedule. The 2026 national CLFS amount is $10.18 and has remained unchanged since 2020. The CLFS amount is the same in every state and locality, with no office or facility payment difference.
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 86611
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 86611. 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 86611 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86611 on the lab fee schedule since 2020
86611 · CLFS 2026 Q4 (current)
$10.18
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.
86611 compared with similar tests
- 86609Bacterial antibodyNo organism-specific code$12.88
- 86611 identifies antibody testing directed at Bartonella. Code 86609 represents bacterium antibody testing rather than the Bartonella-specific test.
- 86617Lyme antibodyConfirmatory assay$15.49
- 86617 is for Lyme disease antibody testing. Choose 86611 when the antibody target is Bartonella.
- 86622Brucella antibodyBrucella-specific serology$8.93
- 86622 identifies Brucella antibody testing; 86611 identifies Bartonella antibody testing. Select the code for the organism tested.
86611 billing questions
When should a biller choose 86611?
Use it when the laboratory service analyzes antibodies to Bartonella. A clinical indication such as suspected cat-scratch disease does not change the organism-specific code.
How does 86611 differ from a Bartonella culture or molecular test?
86611 represents antibody analysis. A culture or molecular assay identifies a different type of laboratory service and should be reported with its own applicable code.
Which specimen is typically submitted?
A blood sample, commonly submitted as serum, is typical for Bartonella antibody testing.
Does Medicare pay 86611 under the physician fee schedule?
No. Medicare pays 86611 through the Clinical Laboratory Fee Schedule; the physician fee schedule lists the test as excluded.
Should Bartonella antibody testing be reported with a Lyme antibody code?
Only when both distinct tests were performed and documented. A Lyme antibody code represents testing for Borrelia burgdorferi, not Bartonella.
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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