CPT code 86756: RSV antibody, serologic testing2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports laboratory analysis for antibodies to RSV when antibody testing, rather than direct detection of the virus, is performed.
Medicare pays $15.89 for 86756 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
$15.89
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 86756 covers
Code 86756 identifies laboratory analysis for antibodies to respiratory syncytial virus (RSV). It reports an antibody assay, not testing that directly detects RSV. An antibody result reflects the immune response and is distinct from evidence of the virus detected by antigen or nucleic acid testing. Select this code when the laboratory service analyzes antibodies to RSV, rather than antibodies to another virus or organism. The code identifies the test target, not an RSV antigen or molecular assay.
Medicare pays 86756 through the Clinical Laboratory Fee Schedule (CLFS). The 2026 national CLFS amount is $15.89 and has remained unchanged since 2020. One national amount applies in every state and locality, with no geographic or office-versus-facility adjustment. The code is excluded from the physician fee schedule by statute and is paid only through 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 86756
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 86756. 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 86756 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86756 on the lab fee schedule since 2020
86756 · CLFS 2026 Q4 (current)
$15.89
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.
86756 compared with similar tests
- 86769COVID-19 antibodyMultiple-step method$42.13
- Code 86756 reports antibodies to RSV; 86769 reports antibodies to SARS-CoV-2. The antibody target determines which code applies.
- 87634RSV testAmplified probe detection$70.20
- Code 86756 analyzes RSV antibodies. Code 87634 detects RSV nucleic acid directly.
- 87807RSV assayDirect visual immunoassay$13.10
- Code 86756 analyzes the antibody response to RSV. Code 87807 detects RSV antigen directly.
86756 billing questions
What does code 86756 test for?
It reports antibody analysis for respiratory syncytial virus (RSV), not antibodies to another virus or organism.
Does this test directly detect active RSV infection?
No. It analyzes antibodies rather than detecting the virus itself, so the result is not direct evidence of RSV in a specimen.
How does 86756 differ from RSV antigen or nucleic acid testing?
Code 86756 is for RSV antibody analysis. Codes 87807 and 87634 identify direct RSV antigen and nucleic acid testing, respectively.
How does Medicare pay for 86756?
Medicare pays it through the CLFS at one national amount, without locality or office-versus-facility adjustment. It is excluded from the physician fee schedule by statute.
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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