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See a sample rate comparisonCPT 86860 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, 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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Transfusion Medicine Procedures |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 86860 |
| Medicaid Fee Schedule | $25.47 median of the 8 states in the free preview · View Medicaid rates for 86860 |
National average reimbursement for CPT 86860 by major payers:
$26.07
$16.62
$27.86
$33.16
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CPT 86860
5 of 25 sample ratesHigher to lower in this preview
Pelham Medical Center
$157.25Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$86.04Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$47.37Published rateMichael Shuler
Athens Orthopedic Clinic, P.A.
$19.67Published rateNevada Eye Care Professionals Little & Stein, Ltd.
Nevada Eye Care Professionals
$8.32Published rate
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See a sample payer proposalCPT 86860 vs. Other Transfusion Medicine Procedures Codes
The CPT 86860 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 86860 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 86860. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86860 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.
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