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See a sample rate comparisonCPT 86905 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 Type Fine-Tuning, This Test Refines Basic Ab0 Blood Typing Prior To Giving A Transfusion. A Sample Is Examined For The Presence Of Antigens (Proteins) On The Surface Of Red Blood Cells.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Transfusion Medicine Procedures |
| Common Place of Service | 81 - Independent Laboratory 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | $3.83 national lab fee schedule rate (2026) · View Medicare rates for 86905 |
| Medicaid Fee Schedule | $3.78 median of the 8 states in the free preview · View Medicaid rates for 86905 |
National average reimbursement for CPT 86905 by major payers:
$3.41
$2.77
$4.89
$6.01
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CPT 86905
5 of 25 sample ratesHigher to lower in this preview
Prisma Health-Upstate, Prisma Health Cancer Inst-Grove
Prisma Health - Upstate
$1,641.88Published rateChristopher Raio
St Francis Hospital
$5.06Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$3.83Published ratePalo Pinto County Hospital District, Palo Pinto General Hospital
$3.20Published rateAscension Seton, Ascension Seton Medical Center Austin
Ascension Seton
$1.46Published rate
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See a sample payer proposalCPT 86905 vs. Other Transfusion Medicine Procedures Codes
The CPT 86905 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 86905 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 |
|---|---|---|
| 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. |
| 86901-CPT | Low | Rh Blood Typing, This Test Refines Basic Ab0 Blood Typing Prior To Giving A Transfusion. If Rh (D) Antigens Are Present The Blood Is Typed + (Positive) And If Not The Blood Is Rh- (Negative). |
| 86904-CPT | Low | Blood Typing For A Match, Before A Transfusion Blood Is Checked To Ensure A Match Between Donor And Recipient. The Testing Can Be Done By Adding A Substance To The Recipients Blood Sample Or By Mixing The Sample With A Small Amount Of Donor Blood. |
| 86905-CPT | Low | Blood Type Fine-Tuning, This Test Refines Basic Ab0 Blood Typing Prior To Giving A Transfusion. A Sample Is Examined For The Presence Of Antigens (Proteins) On The Surface Of Red Blood Cells. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86905. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86905 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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