Blood test for antibodies against cyclic citrullinated peptide, a highly specific marker that supports a diagnosis of rheumatoid arthritis.
- Medicare
- $0.00
- Work RVU
- 0
- Global, days
- Region
- Multi-region
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 2 cited references ↓
- Joint pattern: symmetric, small joints, number involved
- Morning stiffness duration
- Imaging findings such as erosions
- Diagnosis such as polyarthritis or suspected rheumatoid arthritis
- Lab report with CCP result
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 2 cited references ↓
Anti-CCP antibody testing is 86200. CCP is more specific for rheumatoid arthritis than rheumatoid factor, and it can be positive years before the disease is obvious. Orthopedic and hand surgeons order it when a patient shows up with symmetric small joint swelling in the hands or feet, prolonged morning stiffness, or erosions on X-ray that do not look like osteoarthritis.
It matters for surgical planning too. A positive CCP in a patient headed for joint replacement points to inflammatory disease, which changes infection risk and how disease-modifying drugs are held around surgery.
CCP is typically ordered with rheumatoid factor (86430 or 86431). Both are billable. Repeating CCP after a positive result rarely changes management, and payers often deny repeats. The diagnosis should describe the joint pattern, not just generic pain.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0 |
| Practice expense RVU | 0 |
| Malpractice RVU | 0 |
| Total RVU | 0 |
| Medicare national rate | $0.00 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $0.00 |
Common denial reasons
The recurring reasons claims for CPT 86200 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Repeat CCP after a prior positive
- Diagnosis limited to osteoarthritis or injury
- No inflammatory findings documented
- Duplicate billing with reference lab
- Ordered as screening without symptoms
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01Can I bill CCP and rheumatoid factor together?
02Why do payers deny repeat CCP tests?
03Why do orthopedic surgeons order CCP?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/medicare/payment/fee-schedules/clinical-laboratory-fee-schedule-clfs
Mira Scribe
Mira Scribe documents the joint distribution and stiffness duration that point toward inflammatory arthritis, which supports a CCP order.
See how Mira captures CPT 86200 documentation