CPT code 86800: Thyroid antibody, thyroglobulin-specific antibody2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures antibodies against thyroglobulin to evaluate autoimmune thyroid disease or help interpret thyroglobulin testing during thyroid cancer follow-up.
Medicare pays $15.91 for 86800 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
$15.91
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 86800 covers
This laboratory assay measures antibodies directed against thyroglobulin, a protein made by the thyroid. Clinicians may order it when evaluating suspected autoimmune thyroid disease and during follow-up of thyroid cancer when thyroglobulin antibodies can affect interpretation of a thyroglobulin result. The test is commonly performed on a blood specimen by a clinical laboratory and may be ordered by endocrinologists, primary care clinicians, or clinicians managing thyroid cancer.
Report 86800 for the thyroglobulin antibody assay, not for measuring thyroglobulin itself or thyroid function. Medicare pays the test through the CLFS at one national amount in every locality, without geographic or office-versus-facility adjustment; the 2026 national CLFS amount is $15.91, unchanged since 2020. 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 86800
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 86800. 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 86800 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86800 on the lab fee schedule since 2020
86800 · CLFS 2026 Q4 (current)
$15.91
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.
86800 compared with similar tests
- 86376Microsomal antibodyThyroid or liver-kidney$14.55
- Use 86800 for antibodies to thyroglobulin; use 86376 for thyroid peroxidase (microsomal) antibodies. They identify different thyroid autoantibodies.
- 84432ThyroglobulinSerum tumor marker$16.06
- Code 86800 measures antibodies against thyroglobulin. Code 84432 measures thyroglobulin, the thyroid protein itself.
- 84443TSH testThyroid-stimulating hormone$16.80
- Code 84443 measures thyroid-stimulating hormone, a thyroid function marker; 86800 measures a thyroid-directed antibody.
86800 billing questions
Is 86800 the same test as a thyroglobulin measurement?
No. 86800 measures antibodies against thyroglobulin; 84432 measures thyroglobulin itself.
How does 86800 differ from a thyroid peroxidase antibody test?
86800 measures antibodies to thyroglobulin. Code 86376 is used for a thyroid peroxidase, also called microsomal, antibody assay.
When might thyroglobulin antibodies be checked with thyroglobulin?
They may be measured during thyroid cancer follow-up because thyroglobulin antibodies can affect interpretation of the thyroglobulin result.
What documentation supports reporting 86800?
Document the order and the performed thyroglobulin antibody assay, along with the clinical reason, such as evaluation of autoimmune thyroid disease or thyroid cancer follow-up.
How does Medicare pay for 86800?
Medicare pays it through the CLFS at one national amount across localities, with no office-versus-facility difference.
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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