What is the standard insurance baseline for CPT 86828?

The standard insurance baseline reimbursement rate is $62.91. This represents the customary allowable amount established across standard fee schedules.

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CPT 86828Medical Service

Assessment of Antibodies to Class I and Class Ii Human Leukocyte Antigens Hla Antigens

Q: What do doctors typically charge for Assessment of Antibodies to Class I and Class Ii Human Leukocyte Antigens Hla Antigens?

The nationwide median physician charge for Assessment of Antibodies to Class I and Class Ii Human Leukocyte Antigens Hla Antigens (CPT 86828) is $313.46. Doctor billed charges vary based on geographic region, setting, and overhead.

Assessment of antibodies to class i and class ii human leukocyte antigens (hla) antigens. Clinical pricing breakdown and utilization metrics across 5 practicing doctors nationwide.

$313.46

Peer Median Charge

Gross billed rate

$62.91

Standard Baseline

Customary allowable

5.0x

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 $313.46. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $62.91 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 86828 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"