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86355 B cells total count

What 86355 is

CMS fee schedule short descriptor: B cells total count.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 86355 (CY2026)

This code has no Physician Fee Schedule rate: Statutory exclusion - not payable under the Physician Fee Schedule. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps 86355 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 86355? These codes are bundled into it

86355 is a Column 1 code in 5 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
80503Path clin consltj sf 5-201 - modifier may bypassCheck pair
80504Path clin consltj mod 21-401 - modifier may bypassCheck pair
80505Path clin consltj high 41-601 - modifier may bypassCheck pair
80506Path clin consltj prolng svc1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

86355 is bundled into these codes

86355 appears as a Column 2 code in 13 active edits. Reported with one of these Column 1 codes on the same date of service, 86355 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0018M1Check pair
0062U1Check pair
0431U1Check pair
81560Trnsplj pd lvr&bwl cd154+cll1Check pair
86152Cell enumeration & id1Check pair
861531Check pair
86825Hla x-math non-cytotoxic1Check pair
86826Hla x-match noncytotoxc addl1Check pair
88182Cell marker study1Check pair
88184Flowcytometry/ tc 1 marker1Check pair
88187Flowcytometry/read 2-81Check pair
88188Flowcytometry/read 9-151Check pair
88189Flowcytometry/read 16 & >1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.