CPT code 86753: Protozoan antibody, not otherwise specified2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Antibody testing for a protozoan parasite when the target is not represented by a more specific organism code.
Medicare pays $12.39 for 86753 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
$12.39
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 86753 covers
This laboratory assay evaluates antibodies directed against a protozoan parasite when the target does not have a more specific organism code. It measures the antibody response rather than detecting the parasite itself. Use this code for a protozoan antibody assay whose target is not otherwise represented by a specific organism code. For example, malaria and Toxoplasma antibody testing have more specific codes. The code does not identify a particular protozoan species or antibody class, so documentation should support the target and assay performed.
Medicare pays this test through the CLFS, with one national amount per code and no locality or office/facility adjustment. The 2026 national CLFS amount is $12.39, unchanged from 2020 through 2026. The test is paid only from the CLFS.
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 86753
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 86753. 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 86753 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86753 on the lab fee schedule since 2020
86753 · CLFS 2026 Q4 (current)
$12.39
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.
86753 compared with similar tests
- 86750Malaria antibodyPlasmodium-specific$13.19
- This code is for a protozoan antibody assay without a more specific organism code; 86750 identifies malaria antibody testing.
- 86777Toxoplasma antibody$14.39
- Use 86777 for Toxoplasma antibody testing. Use this code when the protozoan target does not have a more specific organism code.
- 86778Toxoplasma antibodyIgM antibody$14.41
- 86778 identifies Toxoplasma IgM antibody testing; this code is for a protozoan antibody assay without a more specific organism code.
86753 billing questions
When should this code be used instead of a malaria antibody code?
Use this code when the protozoan antibody assay does not have a more specific organism code. For malaria antibody testing, use 86750.
How does this code differ from the Toxoplasma antibody codes?
Use 86777 for Toxoplasma antibody testing and 86778 for Toxoplasma IgM antibody testing. This code is for a protozoan antibody assay without a more specific organism code.
Does this test detect the parasite itself?
No. It evaluates antibodies directed against a protozoan parasite rather than detecting the parasite.
What should the documentation identify?
Documentation should support the protozoan antibody assay performed and its target, particularly when no more specific organism code applies.
How does Medicare pay this test?
Medicare pays it under the CLFS using one national amount per code, with no geographic or office/facility adjustment.
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
Fee sheets
Put 86753 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet