Surgical · General

86140

Measurement of C-reactive protein, an acute phase marker that rises quickly with infection or inflammation and falls as it resolves.

3 sources ↓

Medicare
$0.00
Work RVU
0
Global, days
Region
General
Drawn from CMS

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 3 cited references ↓

  • Concern for infection or inflammation, with findings
  • Diagnosis such as painful prosthesis, wound infection, or osteomyelitis
  • Order specifying standard CRP
  • For serial testing, how results are guiding treatment
  • Lab report with CRP value

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 3 cited references ↓

Few labs earn their keep in orthopedics like a standard CRP, billed as 86140. CRP rises within hours of infection and drops quickly with treatment, so it is used to screen for periprosthetic joint infection, to evaluate post-op wound concerns, to work up septic arthritis or osteomyelitis, and to track response to antibiotics.

CRP is usually ordered with ESR. Bill both when both were run. Do not confuse 86140 with high-sensitivity CRP (86141), which is a cardiovascular risk test. Ortho infection workups use the standard assay. If the lab reports hs-CRP, bill 86141 and expect the diagnosis to be questioned in an ortho context.

Serial CRPs during treatment are covered when notes show the trend is guiding care, such as timing of a second-stage revision. Some CRP methods are CLIA-waived. Offices running them should add QW on Medicare claims.

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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$0.00

Common denial reasons

The recurring reasons claims for CPT 86140 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

  • hs-CRP billed as 86140 or vice versa
  • Diagnosis does not suggest inflammation
  • Frequent serial testing without documented decisions
  • Missing QW for a waived office test
  • Duplicate claim with reference lab

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 3 cited references ↓

01What is the difference between 86140 and 86141?
86140 is standard CRP for infection and inflammation. 86141 is high-sensitivity CRP for cardiac risk.
02Can I bill CRP and ESR on the same day?
Yes. They are separate tests and are routinely ordered together.
03How often can CRP be repeated during treatment?
As often as clinically needed, but the notes must show each result informs a decision. Daily repeats without changes draw denials.

Sources & references

Editorial content was developed using the following public sources.

  1. 01CMS Physician Fee Schedule 2026
  2. 02
    cms.gov
    https://www.cms.gov/medicare/payment/fee-schedules/clinical-laboratory-fee-schedule-clfs
  3. 03
    cms.gov
    https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments

Mira Scribe

Mira Scribe records the findings that raise infection concern and the plan the lab results feed, so serial CRPs read as part of active treatment.

See how Mira captures CPT 86140 documentation

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