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 86945 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.
Irradiation Of Blood Product, Irradiation Of Blood Product Each Unit (Closest Clinically Equivalent Code(S) Deleted In 1993 86342)
| 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 86945 |
| Medicaid Fee Schedule | $28.69 median of the 8 states in the free preview · View Medicaid rates for 86945 |
National average reimbursement for CPT 86945 by major payers:
$27.99
$16.16
$26.40
$31.15
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 86945.
CPT 86945
5 of 25 sample ratesHigher to lower in this preview
Oconee Medical Center
Prisma Health - Upstate
$179.16Published rateAll Ways Homecare Inc
$35.00Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$19.87Published rateGraham Regional Medical Center, Graham General Hsopital Physicians
$13.00Published rateBellville Hospital District, Bellville General Hospital
$9.60Published 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 86945 vs. Other Transfusion Medicine Procedures Codes
The CPT 86945 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 86945 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 |
|---|---|---|
| 86923-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. |
| 86927-CPT | Low | Plasma Thawing Services, Blood And Blood Products Are Frozen For Long-Term Storage. Each Unit Is Thawed Only As It Is Needed. |
| 86945-CPT | Low | Irradiation Of Blood Product, Irradiation Of Blood Product Each Unit (Closest Clinically Equivalent Code(S) Deleted In 1993 86342) |
| 86999-CPT | High | Transfusion Procedure, Transfusion Of One Or More Units Of Blood Or Blood Product. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86945. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86945 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 86945) and we'll show you how you compare in 15 minutes or less.