Billing code 86486: Skin testMedicare rate & RVUs in Guam
Reports the technical performance of a skin response test for each antigen that does not have its own named billing code skin-test code.
Medicare pays $7.41 for 86486 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 86486 covers
86486 represents the technical work of performing a skin response test with an antigen that lacks its own named billing code skin-test code. A clinician exposes the skin to the selected antigen and records the resulting local response. The antigen and testing method should be identifiable in the record. This is distinct from routine immediate-type allergy testing, which has dedicated allergy test codes. The service may be performed in a clinic or another setting where antigen-specific skin testing is conducted.
Report one unit for each distinct unlisted antigen tested, not one unit for the encounter. Documentation should identify the antigen, the number tested, the testing procedure, and the observed response. CMS classifies 86486 as technical-component-only: it represents test performance, while a separate code covers interpretation. Keep the interpretive service distinct in the record and report it under the applicable interpretation code. When the antigen has its own named skin-test code, use that specific code instead.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
86486 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $7.41 | Unavailable |
How the 86486 rate is calculated
Each of 86486’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 86486
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.00Practice expense 0.19Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 86486
The CMS indicators that decide how 86486 is paid alongside other services.
CMS payment indicators · 86486
Skin test
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
86486 compared with similar codes
Compare codes
86486 vs 86485 vs 95004 vs 95024: national Medicare rates
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How to choose
- 86485Skin test candida
- 86485 is specific to Candida skin testing. Choose 86486 only when the antigen tested has no named billing code skin-test code.
- 95004Allergy skin prick test
- 95004 covers percutaneous immediate-type allergen testing. It is not the unlisted-antigen skin-response service represented by 86486.
- 95024Intradermal allergy test
- 95024 covers intradermal immediate-type allergen testing. Use 86486 for an unlisted-antigen skin test, not routine immediate allergy testing.
86486 billing questions
When should 86486 be chosen over 86485?
Use 86485 for a Candida skin test. Use 86486 when the tested antigen lacks its own named billing code skin-test code.
Does 86486 include interpretation?
No. CMS identifies 86486 as technical-component-only; a separate code covers interpretation.
How many units should be reported?
Report one unit for each distinct unlisted antigen tested. Document the antigen and the number of antigens tested.
What documentation supports the service?
Record the antigen tested, the testing procedure, and the observed skin response. Keep documentation of the separate interpretation distinct from the technical service.
Is 86486 the same as an allergy skin test?
No. Codes such as 95004 and 95024 describe immediate-type allergen testing by specified methods; 86486 is for an unlisted antigen skin test.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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