CPT code 86077: Blood bank service, complex crossmatch interpretation2026 Medicare rate & RVUs in Maine
Reports a physician’s interpretation of complex red-cell compatibility testing or evaluation of an alloantibody during transfusion planning.
Medicare pays $49.28–$50.65 for 86077 in the office in Maine, from Rest of Maine to Southern Maine, ME. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 86077 covers
A transfusion medicine physician or pathologist uses this service to interpret difficult red-cell compatibility findings, such as a complex crossmatch or an unexpected alloantibody that affects selection of compatible units. It may arise during pretransfusion testing for a patient with a prior transfusion, pregnancy, or known red-cell antibody. The physician assesses the serologic findings and their implications for transfusion support; routine testing performed by laboratory staff alone is not this physician service.
Report 86077 for the physician’s interpretive work, not for the laboratory’s technical performance of a crossmatch or antibody test. The record should support the complexity and clinical purpose of the interpretation, including relevant test findings and the physician’s conclusion or recommendation. CMS assigns physician work, practice expense, and malpractice RVUs; practice expense has separate office and facility values. The code is distinct from physician services for investigating a transfusion reaction or authorizing use of a blood product.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 86077 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | $49.28 | $38.53 |
| Southern Maine, ME | $50.65 | $39.06 |
How the 86077 rate is calculated
Each of 86077’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 86077
RVUs × geographic indexes × conversion factor
Work0.92
0.92 RVUs× 1.000 GPCI
Practice expense0.57
0.57 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
1.5400
Conversion factor
$33.4009
Medicare rate
$51.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 86077
86077 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 86077
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$51.44
- Non-facility (office)
- $51.44
- Facility
- $39.75
Higher because the practice carries its own overhead.
86077 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 86920Compatibility testImmediate spin, per unit
- 86920 represents laboratory performance of antiglobulin compatibility testing. 86077 is the physician’s interpretation of complex compatibility findings.
- 86870RBC antibody IDPer antibody panel
- 86870 reports red-cell antibody identification testing. 86077 reports physician interpretation of an alloantibody’s compatibility implications.
- 86078Blood bank serviceTransfusion reaction investigation
- 86078 is for physician investigation of a transfusion reaction; 86077 concerns complex pretransfusion compatibility or alloantibody interpretation.
- 86079Blood bank serviceTransfusion authorization
- 86079 reports physician authorization to use a blood product. Choose 86077 when the service is interpretation of complex crossmatch or alloantibody findings.
86077 billing questions
Is 86077 reported for every routine crossmatch?
No. It represents physician interpretation of complex compatibility findings or alloantibody evaluation, rather than the laboratory’s routine performance of a crossmatch.
How does 86077 differ from the laboratory crossmatch code?
86077 describes the physician’s interpretive service. Codes such as 86920 describe technical compatibility testing performed by the laboratory.
What documentation supports 86077?
Document the relevant compatibility or antibody findings, why physician interpretation was needed, and the interpretation or transfusion recommendation.
Should 86077 be used for a transfusion reaction workup?
No. Physician investigation of a suspected transfusion reaction is represented by 86078, not 86077.
When is 86079 a better fit?
Use 86079 for a physician’s authorization to use a blood product; 86077 is for interpretation of complex crossmatch or alloantibody findings.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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