CPT code 86713: Legionella antibody2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Legionella antibody testing measures the immune response to this waterborne bacterium and is reported when a laboratory performs organism-specific antibody analysis.
Medicare pays $15.30 for 86713 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
$15.30
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 86713 covers
86713 identifies laboratory analysis for antibodies to Legionella, a waterborne bacterium. The result reflects an antibody response to this organism rather than direct detection of the bacterium. Report the code when a laboratory performs Legionella-specific antibody analysis; it distinguishes this target from antibody tests for other pathogens. The antibody result concerns the patient's immune response, not the presence of Legionella organisms in the tested material.
Medicare pays 86713 through the CLFS. CMS sets one national amount for every state and locality; no geographic adjustment or office-versus-facility difference changes the payment. The 2026 national amount is $15.30, unchanged since 2020. The code is excluded from the physician fee schedule by statute, so payment is through the CLFS only.
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 86713
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 86713. 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 86713 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86713 on the lab fee schedule since 2020
86713 · CLFS 2026 Q4 (current)
$15.30
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.
86713 compared with similar tests
- 86738Mycoplasma antibodyMycoplasma-specific serology$13.24
- 86738 identifies Mycoplasma antibody testing. Use 86713 when the antibody target is Legionella.
- 86710Influenza antibodySerologic testing$13.55
- 86710 identifies influenza virus antibody testing. Use 86713 for antibodies to Legionella.
- 86720Leptospira antibody$16.20
- 86720 identifies Leptospira antibody testing. The organism-specific antibody test determines whether 86720 or 86713 applies.
86713 billing questions
When should 86713 be selected instead of another infectious-disease antibody code?
Use 86713 when the laboratory test is for antibodies to Legionella. Select a different organism-specific code when the antibody test targets another pathogen, such as Mycoplasma or influenza.
Does 86713 identify a Legionella antibody test or a direct organism test?
It identifies antibody analysis, which assesses the immune response to Legionella. It is not a code for direct detection of the organism.
How does Medicare pay 86713?
Medicare pays the test through the CLFS using one national amount across localities and settings. The code is excluded from the physician fee schedule by statute.
Is there a physician interpretation payment for 86713?
The code is paid only through the CLFS; it is excluded from the physician fee schedule by statute.
Should 86713 be reported for antibodies to more than one pathogen?
Report this code for the Legionella antibody test. Use the applicable organism-specific code for a separate antibody test targeting another pathogen.
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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