CPT code 86762: Rubella antibody2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Rubella antibody testing helps clinicians assess prior exposure or immune status, including during pregnancy-related screening and evaluation of suspected rubella infection.
Medicare pays $14.39 for 86762 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
$14.39
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 7 sections
What 86762 covers
This laboratory serology test analyzes a patient specimen for antibodies to rubella virus, which causes German measles. Clinicians commonly order rubella antibody testing to assess immunity, including as part of prenatal screening or when evaluating possible rubella infection. A clinical laboratory performs the assay and reports the result to the ordering clinician, such as an obstetrician, primary care clinician, or infectious disease specialist.
Report 86762 for the rubella antibody analysis; distinguish it from antibody testing for other viruses, including rubeola and varicella-zoster. Medicare pays this test only through the Clinical Laboratory Fee Schedule (CLFS), at one nationally set amount that applies across localities, without geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $14.39, unchanged since 2020. The code is excluded from the physician fee schedule, and payment is 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 86762
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 86762. 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 86762 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86762 on the lab fee schedule since 2020
86762 · CLFS 2026 Q4 (current)
$14.39
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.
86762 compared with similar tests
- 86765Measles antibody$12.88
- 86762 is for rubella antibody testing; 86765 is for rubeola antibody testing. Select according to the virus the laboratory is testing.
- 86735Mumps antibodyMumps-specific serology$13.05
- 86762 tests for rubella antibodies, while 86735 tests for mumps antibodies. They represent different viral assays, even when ordered as part of an immunity assessment.
- 86787VZV antibody$12.88
- 86762 is the rubella antibody test; 86787 is for varicella-zoster antibodies. Use the code matching the pathogen tested.
86762 billing questions
When should 86762 be selected instead of 86765?
Use 86762 for antibodies to rubella virus. Code 86765 is for rubeola, the measles virus; the two tests address different infections.
Does this code identify an antibody class, such as IgG or IgM?
The code identifies rubella antibody testing without specifying an antibody class. Use the laboratory order and result details to identify the assay performed.
How is Medicare payment determined for 86762?
Medicare pays the test through the CLFS at one national amount applicable across localities, with no office-versus-facility difference. It is excluded from the physician fee schedule.
Should 86762 be reported with an antibody test for another virus?
Report 86762 for the rubella assay and the appropriate separate code when a different viral antibody assay is also performed. Do not use 86762 to represent antibodies to another virus.
What documentation supports reporting this test?
Documentation should identify the rubella antibody test ordered and the clinical reason, such as assessment of rubella immunity or evaluation of possible infection.
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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