CPT code 86757: Rickettsia antibody2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Serologic analysis for antibodies to Rickettsia bacteria, reported when a clinician evaluates a patient for suspected rickettsial infection.
Medicare pays $19.35 for 86757 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
$19.35
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 86757 covers
This serologic test analyzes a patient sample for antibodies to Rickettsia bacteria. Clinicians may order it when evaluating an illness that raises concern for rickettsial infection, including after possible exposure to a tick- or louse-borne agent. Clinical laboratories perform and report the antibody analysis for the ordering clinician; the result is considered alongside the patient’s symptoms and exposure history.
Report 86757 for the Rickettsia antibody analysis performed. The 2026 national CLFS amount is $19.35 and has been unchanged since 2020. Medicare pays one CLFS amount per code nationwide, without a locality or office-versus-facility adjustment. The test is paid through the CLFS rather than the physician fee schedule.
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 86757
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 86757. 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 86757 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86757 on the lab fee schedule since 2020
86757 · CLFS 2026 Q4 (current)
$19.35
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.
86757 compared with similar tests
- 86738Mycoplasma antibodyMycoplasma-specific serology$13.24
- 86757 analyzes for antibodies to Rickettsia; 86738 targets Mycoplasma antibodies. Select the code for the organism being tested.
- 86756RSV antibodySerologic testing$15.89
- 86756 is for respiratory virus antibody analysis, not Rickettsia. The suspected or requested pathogen determines which code applies.
- 86618Lyme antibodyLyme disease antibody$17.03
- 86618 is used for Borrelia burgdorferi (Lyme disease) antibody testing. Use 86757 for a Rickettsia antibody analysis.
86757 billing questions
When should 86757 be chosen over another infectious-disease antibody code?
Use 86757 when the requested antibody analysis targets Rickettsia. Choose a different organism-specific code when the test targets another pathogen, such as Mycoplasma or a respiratory virus.
Does 86757 identify the organism directly?
No. It analyzes for antibodies to Rickettsia, rather than directly detecting the bacteria.
How does Medicare pay for 86757?
Medicare pays it under the CLFS at one national amount per code, with no locality or office-versus-facility adjustment. It is paid only through the CLFS.
Does 86757 have a physician fee schedule payment?
No. The test is excluded from the physician fee schedule and is paid only through the CLFS.
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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