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Describe a service in plain words, or type a CPT/HCPCS code.

Cyclic Citrullinated Peptide Antibody

CPT 86200

Ordered when rheumatoid arthritis is suspected, typically alongside rheumatoid factor and inflammatory markers.

No national payment amount

Status X is not separately payable under the PFS.

Did Medicare pay separately for CPT 86200 in Q1 2019? Copy link

Not at a published national rate. CPT 86200 carries status X (statutory exclusion) in the Q1 2019 release. The statutory definition of physician services does not include this item. Treat the blank amount as unpriced, not as $0.

Source: Physician relative value file (Q1 2019) · effective January 2019 · materially updated Aug 4, 2026 · compact facts

Can you bill it with another code? Copy link

Enter a second CPT or HCPCS code billed the same date of service to check the current NCCI procedure-to-procedure edit between it and 86200.

See every current NCCI pair for 86200 →

How often 86200 is billed Copy link

Across Original Medicare in CY2024, 86200 ranked #452 of the 7,879 CPT codes billed to Medicare that year, ranked by patients served or total allowed dollars.

Beneficiaries
272,849
Office + facility patients combined
Services
301,888
Times it was billed
Allowed
$3.8M
Total Medicare allowed dollars
Compare: ↑ #451 more popular · 86235 ↓ #454 less popular · 93321

2024 Medicare fee-for-service only, national totals — Medicare Advantage, Medicaid and commercial volume are excluded, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q1 2019 fee schedule the rates above come from.

Global period: what 86200's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

Modifiers that report work outside 86200's global period
Modifier Reports
-25 A significant, separately identifiable E/M on the same day as the procedure, beyond its usual pre- and post-operative care.

A modifier reports what happened; it does not by itself make a service payable. Documentation has to support it.

Common questions Copy link

Why is there no payment amount for 86200?

Its status indicator is X (statutory exclusion). The statutory definition of physician services does not include this item. The blank is deliberate: the amount is either unknown or paid under another provision, so reading it as $0 would be wrong.

Why would a Medicare claim for 86200 be denied or paid less?

Each item below comes from a CMS indicator on this page — not general billing advice.

  • Its status indicator is X (statutory exclusion) — The statutory definition of physician services does not include this item. See status indicators

Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.

When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Saw this code on your bill? Copy link

For patients
What does CPT code 86200 mean?

CPT code 86200: Cyclic Citrullinated Peptide Antibody. A common example is someone with morning stiffness and swelling in the small joints of both hands that has gone on for weeks. This test helps separate rheumatoid arthritis from other causes of joint pain, and a strong positive supports starting disease-modifying treatment sooner.

Computation & policy
History & related

Rate history by release Copy link

National non-facility amount for 86200 across quarterly releases.

Release Status Non-facility Facility
Q3 2026 Jul 1, 2026 – present X — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 X — —
Q1 2026 Jan 1, 2026 – Mar 31, 2026 X — —

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Source & method

Show sources

This is computed from CMS's Medicare Physician Fee Schedule Q1 2019 release (schedule pfs, effective January 2019). National amounts apply a GPCI of 1.000 and leave sequestration off. The status indicator decides payability, never the RVU values, so a blank RVU stays blank. Releases are immutable: a rate retrieved for a past quarter always reflects that release. Commercial and cash-pay figures anywhere on this page are arithmetic on the Medicare amount, using commonly cited reimbursement ranges. They're illustrative, and no nationwide claims database stands behind them. Our methodology covers all of this in depth — sourcing, parsing, versioning, and how claims are cross-checked before they ship.

Description written from primary sources: CMS Medicare Physician Fee Schedule Relative Value Files. Not derived from AMA CPT descriptor text.

Physician relative value file (Q1 2019) · rvu19a.zip (PPRRVU19_V1213.csv row 14,559)

Use the (i) buttons next to each amount above for the exact row, columns, and math.

Cite this rate

This link keeps pointing at the Q1 2019 figures, even after a newer release lands.

CPT 86200 Medicare Physician Fee Schedule rate (Q1 2019). Localis. https://localishealth.com/cpt/86200/2019/A