CPT code 86625: Campylobacter antibody2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures antibodies to Campylobacter, an intestinal bacterium, for laboratory reporting in an evaluation involving suspected Campylobacter infection.
Medicare pays $13.12 for 86625 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
$13.12
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 86625 covers
86625 identifies laboratory analysis for antibodies to Campylobacter, an intestinal bacterium. It measures the patient's antibody response rather than directly detecting the organism. The test is relevant to evaluation for Campylobacter infection, but it is not a stool culture or a molecular pathogen-panel result. Clinical laboratories perform and report this antibody analysis; clinicians use the result with the clinical evaluation.
Report 86625 for the Campylobacter antibody analysis. Medicare pays the test under the CLFS at one national amount that applies across states and localities, without an office-versus-facility payment difference. The 2026 national CLFS amount is $13.12 and has remained unchanged from 2020 through 2026. The test is paid only under 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 86625
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 86625. 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 86625 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86625 on the lab fee schedule since 2020
86625 · CLFS 2026 Q4 (current)
$13.12
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.
86625 compared with similar tests
- 86609Bacterial antibodyNo organism-specific code$12.88
- 86625 targets Campylobacter. Code 86609 describes a bacterium antibody test with a different target.
- 87045Stool cultureAerobic, Salmonella and Shigella$9.44
- Code 87045 is a stool culture that detects bacterial growth; 86625 measures antibodies to Campylobacter.
- 87507GI pathogen panel12–25 targets$416.78
- Code 87507 reports molecular detection of multiple gastrointestinal pathogens; 86625 measures antibodies to Campylobacter.
86625 billing questions
When is 86625 used instead of a stool culture?
86625 reports an antibody analysis; a stool culture detects bacterial growth from a stool specimen. They represent different testing methods.
Does 86625 directly detect Campylobacter?
No. It measures antibodies to Campylobacter rather than detecting the bacterium itself.
Is 86625 a gastrointestinal pathogen panel?
No. It reports a Campylobacter antibody analysis, not a molecular panel testing for multiple gastrointestinal pathogens.
How does Medicare pay for 86625?
Medicare pays 86625 under the CLFS at one national amount across localities, with no office-versus-facility payment difference.
Can a physician interpretation be billed separately?
86625 is paid only under the CLFS, with no separate physician fee schedule payment for the test.
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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