What is T Cell Count and Ratio (CPT 86361)?

T cell count and ratio. This clinical code is utilized across practices and hospitals for diagnostic and therapeutic service documentation.

What do doctors typically charge for T Cell Count and Ratio?

The nationwide median physician charge for T Cell Count and Ratio (CPT 86361) is $161.99. Doctor billed charges vary based on geographic region, setting, and overhead.

What is the standard insurance baseline for CPT 86361?

The standard insurance baseline reimbursement rate is $26.24. This represents the customary allowable amount established across standard fee schedules.

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CPT 86361Medical Service

T Cell Count and Ratio

T cell count and ratio. Clinical pricing breakdown and utilization metrics across 68 practicing doctors nationwide.

$161.99

Peer Median Charge

Gross billed rate

$26.24

Standard Baseline

Customary allowable

6.2x

National Markup

Charge vs baseline

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $161.99. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $26.24 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 86361 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"