Anti-CCP (Cyclic Citrullinated Peptide)
The Anti-CCP test detects antibodies against citrullinated proteins that are highly specific for rheumatoid arthritis, often appearing before symptoms develop.
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Lab testing services linked from this site are not available to residents of Alaska, Arizona, or Hawaii, unless otherwise noted on the lab's own website.
This publication is not intended to solicit the purchase of laboratory testing from any individual consumer.
What this test measures
The Anti-CCP (anti-cyclic citrullinated peptide) test detects autoantibodies that target citrullinated proteins, modified proteins found in joint tissue. In rheumatoid arthritis, the immune system misidentifies these citrullinated proteins as foreign and produces antibodies against them, driving the inflammatory joint destruction that characterizes the disease.
Anti-CCP antibodies are among the most specific markers available for rheumatoid arthritis, with a specificity of approximately 96%, meaning they are rarely found in healthy individuals or in people with other autoimmune conditions. This gives the test a significant advantage over rheumatoid factor, which can be elevated in a broader range of conditions. Anti-CCP antibodies are present in approximately 60% to 70% of rheumatoid arthritis patients and, notably, can be detected months to years before clinical symptoms appear. This early-detection capability makes the test valuable for both diagnosis and for identifying individuals at high risk of developing the disease.
Who should consider this test
You might consider this test if you are experiencing any of the following:
- Individuals experiencing symptoms suggestive of rheumatoid arthritis should consider this test, including persistent joint pain, morning stiffness lasting more than one hour, swelling in multiple joints, and fatigue.
- Those seeking early detection of rheumatoid arthritis may benefit from testing, as anti-CCP antibodies can be present before significant joint damage occurs and even when joint inflammation is not yet apparent.
- People who have had inconclusive rheumatoid factor results may find anti-CCP testing valuable, as it provides more accurate diagnosis than RF testing alone and can help distinguish rheumatoid arthritis from other inflammatory conditions.
- Patients diagnosed with early arthritis who want to understand their prognosis should consider this test, as positive anti-CCP results may indicate increased risk for severe, erosive joint disease.
- Individuals with a family history of rheumatoid arthritis or those in early stages of joint inflammation may benefit from testing to assess their likelihood of developing RA and guide preventive care decisions.
What to expect
Preparation
No special preparation is needed for the Anti-CCP test. Fasting is not required, and individuals can take their regular medications unless specifically instructed otherwise by their healthcare provider.
Sample Type
The test requires a simple blood draw from a vein in the arm, similar to any routine blood test. The procedure typically takes just a few minutes and involves minimal discomfort.
Collection
A healthcare professional will clean the injection site, insert a small needle to draw the blood sample, and apply a bandage. Normal activities can be resumed immediately after the blood draw.
Turnaround
Results are typically available within 1-3 business days after the laboratory receives the sample. No doctor visit is required to order this test or receive results.
Understanding your results
Results are reported as positive or negative, along with a numerical antibody concentration in units per milliliter (U/mL). A positive result strongly suggests rheumatoid arthritis, particularly when combined with compatible symptoms and elevated inflammatory markers, but it does not confirm the diagnosis in isolation. A negative result does not exclude rheumatoid arthritis either, since roughly 30% to 40% of patients with confirmed disease test negative for anti-CCP. Healthcare providers use the result alongside clinical examination, imaging, rheumatoid factor, and inflammatory markers (ESR, CRP) to arrive at a comprehensive assessment.
| Population | Reference Range | Notes |
|---|---|---|
| Adults | Less than 20 U/mL or EU/mL | Values below 20 units per milliliter are typically considered normal and within reference range |
Reference ranges may vary by laboratory and individual factors. Results should be interpreted by a healthcare provider in the context of your overall health.
What does a “Low” result mean?
Low levels of anti-CCP antibodies may be detected in some individuals but may not be sufficient to produce a positive result. A negative result does not rule out rheumatoid arthritis, as these antibodies are present in only about 60-70% of RA patients, meaning some individuals with the condition may test negative. In asymptomatic individuals, a negative result may suggest a lower risk of developing rheumatoid arthritis in the near future.
What does a “High” result mean?
Elevated anti-CCP antibody levels above 20 U/mL typically indicate the presence of these specific antibodies and may suggest an increased likelihood of rheumatoid arthritis. Higher antibody concentrations are often associated with more aggressive disease progression and may indicate a greater risk of joint damage. Significantly elevated levels may be useful in identifying patients who are more likely to develop erosive joint disease.
Privacy & confidentiality
All test results are kept strictly confidential and are protected under HIPAA regulations. Results are not shared with insurance companies, do not appear on insurance explanation of benefits, and are not automatically added to your medical record.
Frequently asked questions
Related tests
Rheumatoid Factor (RF)
Often tested together with anti-CCP for comprehensive rheumatoid arthritis evaluation
View TestAntinuclear Antibodies (ANA)
Helps differentiate rheumatoid arthritis from other autoimmune conditions
View TestC-Reactive Protein (CRP)
Measures inflammation levels that commonly accompany rheumatoid arthritis
View TestErythrocyte Sedimentation Rate (ESR)
Another marker of inflammation useful in rheumatoid arthritis assessment
View TestRelated conditions
Last reviewed: April 2026
CPT Code: 86200
This test may not be available in: NY, NJ, RI
This page is for informational purposes only and does not constitute medical advice. Always consult with a healthcare provider regarding any health concerns. LevelPanel does not diagnose, treat, or prescribe.
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LevelPanel has no business or affiliate relationship with Quest or LabCorp. These links are provided as a public service.
Lab testing services linked from this site are not available to residents of Alaska, Arizona, or Hawaii, unless otherwise noted on the lab's own website.
This publication is not intended to solicit the purchase of laboratory testing from any individual consumer.
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