CPT code 86817: HLA typing, DR/DQ, multiple antigens2026 Medicare lab fee · Clinical Laboratory Fee Schedule
HLA-DR/DQ typing analyzes multiple antigens for immunologic evaluation associated with autoimmune disease and distinguishes this service from HLA antibody testing.
Medicare pays $106.14 for 86817 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
$106.14
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 86817 covers
86817 identifies multiple HLA-DR and HLA-DQ antigens in an immunologic analysis associated with autoimmune disease. The service concerns DR/DQ antigen typing, not testing for antibodies against HLA. It is distinct from HLA-A, -B, or -C typing and from qualitative HLA antibody testing. Select the DR/DQ typing code according to the antigen count being analyzed; 86817 represents the multiple-antigen service. Codes 86812 and 86813 address HLA-A, -B, or -C typing.
Medicare pays 86817 through the CLFS, with one national amount in every state and locality and no office-versus-facility difference. The 2026 national amount is $106.14, unchanged from 2020 through 2026. The test is paid only through the CLFS, not the physician fee schedule. Report 86817 for the multiple-antigen DR/DQ analysis, not for a qualitative HLA antibody assay.
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 86817
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 86817. 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 86817 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86817 on the lab fee schedule since 2020
86817 · CLFS 2026 Q4 (current)
$106.14
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.
86817 compared with similar tests
- 86816HLA typingDR/DQ, single antigen$30.17
- Both codes concern HLA-DR/DQ typing. Select the code according to antigen count; 86817 represents multiple antigens.
- 86812HLA typingSingle HLA-A, B, or C antigen$25.81
- 86812 addresses HLA-A, -B, or -C typing, not DR/DQ typing.
- 86813HLA typingMultiple HLA antigens$58.00
- 86813 addresses HLA-A, -B, or -C typing, not DR/DQ typing.
- 86828HLA antibodiesBoth HLA classes$64.19
- 86828 is qualitative HLA antibody testing; 86817 identifies HLA-DR/DQ antigens.
86817 billing questions
How do I choose between 86817 and 86816?
Both are HLA-DR/DQ typing codes. Select the code according to the antigen count being analyzed; 86817 represents multiple antigens.
Does 86817 report HLA-A, -B, or -C typing?
No. Codes 86812 and 86813 address HLA-A, -B, or -C typing, while 86817 is for DR/DQ typing.
Does 86817 include HLA antibody testing?
No. HLA typing identifies antigens, while HLA antibody testing evaluates antibodies; these are distinct laboratory services.
What documentation supports reporting 86817?
Documentation should identify DR/DQ typing and the multiple antigens analyzed to support selection of this code.
How does Medicare pay for 86817?
Medicare pays 86817 through the CLFS at one national amount in every state and locality, 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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