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See a sample rate comparisonCPT 86985 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.
Splitting Of Blood Or Blood Pr, Splitting Of Blood Or Blood Products Each Unit (Closestclinically Equivalent Code(S) Deleted In 1993 86587) Splitting Of Blood Or Blood Products Each Unit (Closest
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Transfusion Medicine Procedures |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | 26 - Professional component 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 86985 |
| Medicaid Fee Schedule | $14.26 median of the 8 states in the free preview · View Medicaid rates for 86985 |
National average reimbursement for CPT 86985 by major payers:
$23.59
$13.74
$21.56
$26.34
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CPT 86985
5 of 25 sample ratesHigher to lower in this preview
Prisma Health-Upstate, Prisma Health Cancer Inst-Seneca
Prisma Health - Upstate
$782.16Published rateDa Pediatric Rehabilitation
$55.00Published rateRestorative Health Rehabilitation Inc
$35.00Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$17.95Published rateBaptist Health Care, Inc., Baptist Home Healt Care And Medical Equipment
Baptist Health Care Inc
$6.88Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 86985 vs. Other Transfusion Medicine Procedures Codes
The CPT 86985 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 86985 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 |
|---|---|---|
| 86890-CPT | Low | Autologous Blood Or Component, Autologous Blood Or Component Collection Processing Andstorage Predeposited (Closest Clinically Equivalent Code Deleted In 1993 86128) |
| 86891-CPT | Low | Autologous Blood Or Component, Autologous Blood Or Component Collection Processing Andstorage Intra- Or Postoperative Salvage (Closest Clinically Equivalent Code(S) Deleted In 1993 86130) |
| 86930-CPT | Low | Frozen Blood Preparation For, Frozen Blood Preparation For Freezing Each Unit(Closest Clinically Equivalent Code(S) Deleted I N 1993 86265) |
| 86985-CPT | Low | Splitting Of Blood Or Blood Pr, Splitting Of Blood Or Blood Products Each Unit (Closestclinically Equivalent Code(S) Deleted In 1993 86587) Splitting Of Blood Or Blood Products Each Unit (Closest |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86985. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86985 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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