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See a sample rate comparisonHealthcare 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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Transfusion Medicine Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | TC - Technical component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 86977 |
| Medicaid Fee Schedule | $51.415 median of the 8 states in the free preview · View Medicaid rates for 86977 |
National average reimbursement for CPT 86977 by major payers:

$26.68

$18.44

$28.97

$36.40
Choose a payer to see a sample of rates for CPT 86977.
Greenville Health System, Ghs Patewood Memorial Hospital
Prisma Health - Upstate
Christopher Raio
Good Samaritan Hosptial Medical Center
Restorative Health Rehabilitation Inc
Christopher Raio
Good Samaritan Hosptial Medical Center
Sunrise Home Health Care Inc.
Sunrise Home Health Care Inc
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Rate Benchmarking
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See a sample payer proposalCPT 86977 vs. Other Transfusion Medicine Procedures Codes
The CPT 86977 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 86977 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 |
|---|---|---|
| 86975-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. |
| 86976-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. |
| 86977-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. |
| 86978-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 86977. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86977 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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