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86817 Hla typing dr/dq

What 86817 is

CMS fee schedule short descriptor: Hla typing dr/dq.

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 86817 (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 86817 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 86817? These codes are bundled into it

86817 is a Column 1 code in 2 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
86816Hla typing dr/dq1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

86817 is bundled into these codes

86817 appears as a Column 2 code in 11 active edits. Reported with one of these Column 1 codes on the same date of service, 86817 is the code that denies.

Column 1 codeShort descriptionModifier indicator
81370Hla i & ii typing lr0Check pair
81371Hla i & ii type verify lr0Check pair
81373Hla i typing 1 locus lr0Check pair
81375Hla ii typing ag equiv lr0Check pair
81376Hla ii typing 1 locus lr0Check pair
81377Hla ii type 1 ag equiv lr0Check pair
81378Hla i & ii typing hr0Check pair
81380Hla i typing 1 locus hr1Check pair
81381Hla i typing 1 allele hr1Check pair
81382Hla ii typing 1 loc hr0Check pair
81383Hla ii typing 1 allele hr0Check 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.