CPT code 86813: HLA typing, multiple HLA antigens2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports multiple-antigen HLA-A, HLA-B, or HLA-C typing to characterize HLA status during immunologic evaluation of autoimmune disease.
Medicare pays $58.00 for 86813 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
$58.00
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 86813 covers
Laboratory HLA typing identifies antigens at the HLA-A, HLA-B, or HLA-C locus. Code 86813 represents multiple-antigen typing at one of those loci for immunologic evaluation of autoimmune disease. The result characterizes the patient's HLA profile. HLA-DR or HLA-DQ typing is reported with a different code branch.
Report 86813 for multiple-antigen typing at the applicable A, B, or C locus; use 86812 for single-antigen typing at those loci. Medicare pays 86813 only through the CLFS. The 2026 national amount is $58.00, unchanged from 2020 through 2026; one amount applies across localities, without an office or facility difference. The test is excluded from 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 86813
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 86813. 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 86813 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86813 on the lab fee schedule since 2020
86813 · CLFS 2026 Q4 (current)
$58.00
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.
86813 compared with similar tests
- 86812HLA typingSingle HLA-A, B, or C antigen$25.81
- Choose 86813 for multiple-antigen HLA-A, HLA-B, or HLA-C typing; choose 86812 for single-antigen typing at those loci.
- 86816HLA typingDR/DQ, single antigen$30.17
- 86816 is for HLA-DR or HLA-DQ typing in the single-antigen branch. Code 86813 covers multiple-antigen HLA-A, HLA-B, or HLA-C typing.
- 86817HLA typingDR/DQ, multiple antigens$106.14
- Both cover multiple-antigen HLA typing, but 86817 is for DR/DQ loci and 86813 is for A, B, or C loci.
- 86830HLA antibody testClass I, qualitative panel$95.52
- 86830 reports HLA class I phenotype testing, while 86813 reports multiple-antigen typing at an HLA-A, HLA-B, or HLA-C locus.
86813 billing questions
How does 86813 differ from 86812?
86813 is for multiple-antigen HLA-A, HLA-B, or HLA-C typing. Use 86812 for single-antigen typing at those loci.
Does 86813 include HLA-DR or HLA-DQ typing?
No. Code 86813 covers HLA-A, HLA-B, or HLA-C typing. HLA-DR or HLA-DQ typing is reported with the corresponding code in that branch.
What should the documentation identify?
Document the HLA locus tested and whether the service involved multiple-antigen typing.
Is a physician interpretation billed with 86813?
86813 is paid only through the CLFS and is excluded from the physician fee schedule.
Does Medicare pay a different amount by location or setting?
No. One national CLFS amount applies across localities, with no office or 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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