86812 Hla typing a b or c
What 86812 is
CMS fee schedule short descriptor: Hla typing a b or c.
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 86812 (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.
Medically Unlikely Edit (MUE)
Medicare caps 86812 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 86812? These codes are bundled into it
86812 is a Column 1 code in 1 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 code | Short description | Modifier indicator | |
|---|---|---|---|
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
86812 is bundled into these codes
86812 appears as a Column 2 code in 13 active edits. Reported with one of these Column 1 codes on the same date of service, 86812 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
81370 | Hla i & ii typing lr | 0 | Check pair |
81371 | Hla i & ii type verify lr | 0 | Check pair |
81372 | Hla i typing complete lr | 0 | Check pair |
81373 | Hla i typing 1 locus lr | 0 | Check pair |
81374 | Hla i typing 1 antigen lr | 0 | Check pair |
81375 | Hla ii typing ag equiv lr | 0 | Check pair |
81378 | Hla i & ii typing hr | 0 | Check pair |
81379 | Hla i typing complete hr | 0 | Check pair |
81380 | Hla i typing 1 locus hr | 1 | Check pair |
81381 | Hla i typing 1 allele hr | 1 | Check pair |
81382 | Hla ii typing 1 loc hr | 0 | Check pair |
81383 | Hla ii typing 1 allele hr | 0 | Check pair |
86813 | Hla typing a b or c | 1 | Check 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.