CPT 86235 Pathology/Laboratory

How Much Does Measurement of Antibody for Assessment of Autoimmune Disorder, Any Method Cost?

Also known as: Measurement of antibody for assessment of autoimmune disorder, any method (CPT 86235)

An ANA (antinuclear antibody) blood test that screens for autoimmune conditions like lupus.

Measurement of Antibody for Assessment of Autoimmune Disorder, Any Method (CPT 86235) costs $18 at Medicare rates.

The rates shown below represent the complete Medicare reimbursement for this service. No separate facility fee applies for this type of procedure.

Medicare (Facility)
$18
CMS PFS 2026 national rate

Patient Guide: Measurement of Antibody for Assessment of Autoimmune Disorder, Any Method

What you need to know before your appointment

What to Expect

A blood sample is drawn from your arm. The test detects antibodies that attack your own body cells, which can indicate an autoimmune condition.

How Long Does It Take?

5-10 minutes for the blood draw

Common Reasons Doctors Order This

Lupus screening, joint pain evaluation, fatigue with rash, autoimmune disease workup, Raynaud phenomenon evaluation

How to Prepare

No fasting or special preparation. A positive ANA does not always mean you have an autoimmune disease; your doctor will interpret it in context.

Procedures Commonly Done Together

These procedures are frequently performed alongside Measurement of antibody for assessment of autoimmune disorder, any method

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How to Reduce Your Cost for Measurement of antibody for assessment of autoimmune disorder, any method

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

People Also Ask

Common questions people search for about this procedure

How much does an ANA test cost out of pocket?

On MDsave, the cost of an ANA Test ranges from 5 to 0. Those on high deductible health plans or without insurance can shop, compare prices and save. Read more about how MDsave works.

Source: www.mdsave.com See our data-backed answer →
Is an ANA test worth it?

A healthcare professional orders an ANA test for a suspected autoimmune condition. These include lupus, rheumatoid arthritis, Sjogren syndrome and scleroderma. An ANA test by itself can't confirm a diagnosis. But it can help rule out some conditions.

Source: www.mayoclinic.org See our data-backed answer →
Will insurance cover an ANA test?

Reimbursement for testing for antinuclear antibodies (ANA) is allowed for individuals in whom the clinical suspicion of autoimmune diseases is high based on signs, symptoms and other factors.

Source: www.bluecrossnc.com See our data-backed answer →
Why would a doctor run an ANA test?

What is it used for? An ANA test is used to help diagnose autoimmune disorders, such as: Systemic lupus erythematosus (SLE), the most common type of lupus. Lupus is a chronic (long-lasting) disease that affects many parts of the body, including the joints, skin, heart, lungs, blood vessels, kidneys, and brain.

Source: medlineplus.gov See our data-backed answer →

Frequently Asked Questions

How much does Measurement of antibody for assessment of autoimmune disorder, any method cost?

The Medicare facility rate for Measurement of antibody for assessment of autoimmune disorder, any method is $18. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Measurement of antibody for assessment of autoimmune disorder, any method cost without insurance?

Without insurance, the cost of Measurement of antibody for assessment of autoimmune disorder, any method can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Measurement of antibody for assessment of autoimmune disorder, any method?

Most commercial health insurance plans and Medicare cover Measurement of antibody for assessment of autoimmune disorder, any method when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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