Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 86850 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Blood Autoimmune Test, This Blood Test Checks For The Presence Of Immune Cells (Antibodies) That React To Red Blood Cells As If They Were Harmful. The Test Is Done Prior To Giving A Blood Transfusion Or Childbirth.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Transfusion Medicine Procedures |
| Common Place of Service | 21 - Inpatient Hospital 81 - Independent Laboratory |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $9.77 national lab fee schedule rate (2026) · View Medicare rates for 86850 |
| Medicaid Fee Schedule | $8.99 median of the 8 states in the free preview · View Medicaid rates for 86850 |
National average reimbursement for CPT 86850 by major payers:
$8.06
$7.09
$12.02
$14.61
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 86850.
CPT 86850
5 of 25 sample ratesHigher to lower in this preview
Titus County Hospital District, Titus Regional Medical Center
$11.72Published rateThang Le
Slocum Dickson Medical Group PLLC
$8.10Published rateTatyana Antonevich
Slocum Dickson Medical Group PLLC
$4.09Published rateKenneth Visalli
Slocum Dickson Medical Group PLLC
$4.09Published rateAlexander Harris
Slocum Dickson Medical Group PLLC
$4.09Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 86850 vs. Other Transfusion Medicine Procedures Codes
The CPT 86850 code is part of the Pathology and Laboratory Procedures services used for Transfusion Medicine Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 86850 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 86850-CPT | Low | Blood Autoimmune Test, This Blood Test Checks For The Presence Of Immune Cells (Antibodies) That React To Red Blood Cells As If They Were Harmful. The Test Is Done Prior To Giving A Blood Transfusion Or Childbirth. |
| 86860-CPT | Low | Blood Autoimmune Test, Procedure To Remove An Antibody From The Blood To Determine If An Autoimmune Disorder Is Present And To Remove Any Immune Cells (Antibodies) That React To Red Blood Cells That May Be Harmful. |
| 86870-CPT | Low | Blood Autoimmune Test, This Blood Test Checks For The Presence Of Immune Cells (Antibodies) That React To Red Blood Cells As If They Were Harmful. The Test Is Done Prior To Giving A Blood Transfusion. |
| 86900-CPT | Low | Blood Typing, This Test Combines A Sample Of Whole Blood With Types 0 A B And Ab. By Observing Which Combinations Cause Blood Cells To Clump A Technician Can Match The Sample To A Type. The Test Is Done Before Giving A Transfusion. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86850. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86850 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 86850) and we'll show you how you compare in 15 minutes or less.
Frequently Asked Questions
A CPT (Current Procedural Terminology) code is a standardized set of five-digit codes used by medical professionals to describe medical, surgical, and diagnostic services. They are crucial for understanding healthcare costs because they are universally recognized identifiers for specific procedures, allowing for consistent billing and pricing across different providers and payers. When you look up the cost of a service, using its CPT code ensures you are comparing prices for the exact same procedure.
To find out the cost of a medical procedure or service before you receive it, it's best to use tools designed for price transparency. For specific, localized pricing information, you should use Payerprice's fee schedule lookup tool. By entering the CPT code for your desired service and your specific location, Payerprice can provide you with relevant cost estimates. While insurance benefits will ultimately determine your out-of-pocket costs, this tool offers valuable insights into the base pricing.
Healthcare costs can vary significantly for the same procedure due to several factors. These include differences in a healthcare provider's negotiated rates with insurance companies, the type of facility (e.g., hospital vs. outpatient clinic), geographic location, the specific medical equipment used, and the complexity of the patient's individual case. Each of these elements can influence the final billed amount and the fee schedule for a particular service.
To look up a specific medical procedure's cost using Payerprice, you will primarily need two pieces of information: the CPT code for the procedure and your specific location (e.g., zip code or city/state). The CPT code identifies the exact medical service, while the location helps Payerprice provide geographically relevant fee schedule data, as costs can vary significantly by region.
Payerprice helps you understand potential healthcare costs by providing a fee schedule lookup tool that allows you to search for medical service prices. By inputting the CPT code for a procedure and your specific location, Payerprice delivers relevant pricing information. This empowers you to compare potential costs for services, negotiate with providers, and make more informed decisions about your healthcare, giving you a clearer picture before insurance adjustments.
Payerprice provides fee schedule information based on CPT codes and location, offering a valuable estimate of the baseline cost for a medical service. While the tool provides comprehensive pricing data, your exact out-of-pocket cost will ultimately depend on your specific insurance plan's benefits, deductible, co-insurance, and out-of-pocket maximums. Payerprice serves as an excellent starting point for understanding the underlying costs, but it's always recommended to also contact your insurance provider for a personalized estimate of your final financial responsibility.