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See a sample rate comparisonCPT 86921 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 86921 |
| Medicaid Fee Schedule | $29.145 median of the 8 states in the free preview · View Medicaid rates for 86921 |
National average reimbursement for CPT 86921 by major payers:
$25.24
$16.94
$25.50
$32.70
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CPT 86921
5 of 25 sample ratesHigher to lower in this preview
Prisma Health-Upstate, Prisma Health Cancer Inst-Seneca
Prisma Health - Upstate
$782.16Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$52.63Published rateChristopher Raio
St Joseph Hospital
$37.65Published rateChristopher Raio
Mercy Medical Center
$21.53Published rateAsya Segalene
Allergy & Asthma Of Dupage, S.C.
$3.15Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86921 vs. Other Transfusion Medicine Procedures Codes
The CPT 86921 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 86921 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 86921. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86921 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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