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See a sample rate comparisonCPT 86920 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.
Test For Blood Match, Before Transfusion Donor Blood Is Checked For Compatibility With The Recipient. This Is A Routine Test To Ensure Ab0 Combinations Between Donor And Recipient Do Not Provoke An Immune Reaction. If Information Is On File The Match May Be Done Electronically.
| 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 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 86920 |
| Medicaid Fee Schedule | $31.11 median of the 8 states in the free preview · View Medicaid rates for 86920 |
National average reimbursement for CPT 86920 by major payers:
$29.05
$19.09
$29.59
$36.22
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CPT 86920
5 of 25 sample ratesHigher to lower in this preview
St. Tammany Parish Hospital Service District No 1, St. Tammany Parish Hospital
$460.67Published rateSepideh Mehravaran
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$20.69Published rateTheresa Boyle
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$20.69Published rateDonna Fabri
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$17.57Published rateSusannah Smith
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$17.57Published rate
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See a sample payer proposalCPT 86920 vs. Other Transfusion Medicine Procedures Codes
The CPT 86920 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 86920 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 |
|---|---|---|
| 86920-CPT | Low | Test For Blood Match, Before Transfusion Donor Blood Is Checked For Compatibility With The Recipient. This Is A Routine Test To Ensure Ab0 Combinations Between Donor And Recipient Do Not Provoke An Immune Reaction. If Information Is On File The Match May Be Done Electronically. |
| 86921-CPT | Low | Test For Blood Match, Before Transfusion Donor Blood Is Checked For Compatibility With The Recipient. This Is A Routine Test To Ensure Ab0 Combinations Between Donor And Recipient Do Not Provoke An Immune Reaction. If Information Is On File The Match May Be Done Electronically. |
| 86922-CPT | Low | Test For Blood Match, This Blood Cross-Matching Is Performed When The Recipients Blood Contains Antibodies. The Test Specifically Combines Plasma Samples From Donor And Recipient Prior To A Transfusion. If Clumping Occurs It Means The Donor Blood Is Not Compatible. |
| 86970-CPT | Low | Blood Pretreatment For Test, Before Running A Test Or Identifying Substances A Blood Sample Is Treated. This Can Involve Mixing The Blood With A Dye Drug Or Preservative. Sometimes The Mixture Incubates Until A Necessary Pretest Reaction Occurs. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86920 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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