86485
No office rateSkin test candida
86485 is specific to Candida skin testing. Choose 86486 only when the antigen tested has no named CPT skin-test code.
On this page
CMS RVU26D · Effective 2026-10-01
86486 Skin test Medicare reimbursement rates in Rhode Island
Reports the technical performance of a skin response test for each antigen that does not have its own named CPT skin-test code. Compare 86486 office and facility rates across CMS payment localities in Rhode Island.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 86486 in Rhode Island?
Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$6.85
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Immunology testing
About 86486: Unlisted antigen skin test
Reports the technical performance of a skin response test for each antigen that does not have its own named CPT skin-test code.
86486 represents the technical work of performing a skin response test with an antigen that lacks its own named CPT 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.
CMS billing rules for 86486
- Professional and technical components
- Technical-component-only code: a separate code covers interpretation.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU0.19 · 95%
- Malpractice RVU0.01 · 5%
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 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$3.74
95004 covers percutaneous immediate-type allergen testing. It is not the unlisted-antigen skin-response service represented by 86486.
$7.88
95024 covers intradermal immediate-type allergen testing. Use 86486 for an unlisted-antigen skin test, not routine immediate allergy testing.
Compare 86486 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
$6.85
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 86486 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
10,686
- Code
- 86486
- Physician work
- 0.00
- Practice expense
- 0.19
- Malpractice
- 0.01
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.019 | 0.0000 |
| Practice expense | 0.19 | × 1.033 | 0.1963 |
| Malpractice | 0.01 | × 0.892 | 0.0089 |
| Total RVUs | 0.2052 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$6.85
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1.019 |
| Practice expense | 0.19 | 1.033 |
| Malpractice | 0.01 | 0.892 |
(0 × 1.019 + 0.19 × 1.033 + 0.01 × 0.892) × $33.4009 = $6.85
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 CPT 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
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10,68486481,,Tb ag response t-cell susp,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10,68586485,,Skin test candida,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10,68686486,,Skin test unlisted antign ea,A,,0.00,0.19,,0.19,NA,0.01,0.20,0.20,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10,68786510,,Histoplasmosis skin test,A,,0.00,0.24,,0.24,NA,0.01,0.25,0.25,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10,68886580,,Tb intradermal test,A,,0.00,0.32,,0.32,NA,0.01,0.33,0.33,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10,68986581,,Strptcs pneum antb serot ia,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537