CPT code 86830: HLA antibody test, class I, qualitative panel2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Qualitative testing identifies antibodies reactive with HLA class I antigens using a panel of complete HLA phenotypes, often for transplant histocompatibility assessment.
Medicare pays $95.52 for 86830 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
$95.52
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 86830 covers
This laboratory service assesses antibodies against human leukocyte antigen (HLA) class I. A qualitative panel representing complete HLA phenotypes is used to identify antibody reactivity; methods may include solid-phase assays such as microsphere or bead assays, ELISA, or flow cytometry. Histocompatibility laboratories perform the testing for transplant-related evaluation, including assessment of HLA antibody status in transplant candidates or recipients.
Report 86830 for qualitative class I antibody identification, rather than HLA typing or a class II-only panel. Medicare pays the test only through the CLFS. The 2026 national CLFS amount is $95.52, unchanged since 2020; this amount applies across states and localities, with no office or facility difference. The physician fee schedule excludes the test by statute.
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 86830
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 86830. 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 86830 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86830 on the lab fee schedule since 2020
86830 · CLFS 2026 Q4 (current)
$95.52
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.
86830 compared with similar tests
- 86831HLA antibody panelClass II, qualitative$81.88
- Choose 86830 when the qualitative antibody panel addresses HLA class I; 86831 addresses HLA class II.
- 86832HLA antibody panelClass I, high-definition qualitative$323.75
- 86830 identifies class I antibody reactivity qualitatively using complete HLA phenotypes; 86832 is the high-definition qualitative class I test.
- 86834HLA antibody panelClass I, semiquantitative$357.56
- Use 86830 for qualitative class I antibody identification. Code 86834 describes semiquantitative class I panel testing.
86830 billing questions
When is 86830 appropriate instead of 86831?
Use 86830 for qualitative antibody identification against HLA class I. Code 86831 is the corresponding qualitative panel for HLA class II.
How does 86830 differ from 86832?
Both address HLA class I antibodies, but 86830 describes qualitative identification using a panel of complete HLA phenotypes. Code 86832 is the high-definition qualitative class I option.
What methods can be used for 86830?
Methods may include solid-phase assays using microspheres or beads, ELISA, or flow cytometry.
Is there a separate physician interpretation payment?
Medicare pays 86830 only through the CLFS. The physician fee schedule excludes the test by statute.
Does Medicare payment vary by location or setting?
No. The CLFS amount is national and has no locality or office-versus-facility adjustment.
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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