CPT code 86078: Blood bank service, transfusion reaction investigation2026 Medicare rate & RVUs in Oxnard, CA

A physician investigates a suspected transfusion reaction by evaluating the clinical event and relevant blood bank findings to help determine its cause.

CMS RVU26DEffective Oct 1, 2026One payment locality6.7K Medicare services in 2024

In Oxnard, CA, Medicare pays $55.13 for 86078 in the office and $41.32 when it’s performed in a hospital or facility.

$55.13Office (non-facility)
$41.32Hospital or facility
+7.2%vs the national office rate ($51.44)

Check a contract rate as a % of Medicare · 86078 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 86078 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Oxnard, CA
  2. What 86078 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 86078 covers

This service covers a physician’s investigation of a suspected reaction occurring during or after a blood transfusion. A transfusion medicine physician or pathologist typically reviews the patient’s clinical course and blood bank findings, such as compatibility testing and reaction-workup results, and may discuss the findings with the treating team. The investigation supports decisions about the reaction’s cause and the patient’s transfusion care in a hospital or blood bank setting.

Report 86078 for the physician’s reaction investigation, rather than for an individual laboratory assay or simply because a transfusion reaction workup was ordered. Documentation should identify the suspected reaction, the records and test results reviewed, the physician’s assessment, and any consultation or recommendations. Distinct laboratory tests performed during the workup are reported according to the services actually performed. CMS physician fee schedule values for this code reflect physician work and practice expense.

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.

How Oxnard, CA compares for 86078

Across 109 of 109 payment localities, the office rate for 86078 runs from $47.94 in Arkansas to $67.29 in Alaska. Oxnard, CA pays $55.13. The RVUs are the same everywhere; the geographic indexes change the dollars.

86078 in Oxnard, CA vs other payment areas
  1. Oxnard, CA · this page$55.13
  2. Bakersfield, CA · California$53.20−$1.93
  3. Chico, CA · California$53.01−$2.12
  4. El Centro, CA · California$53.02−$2.11
  5. Fresno, CA · California$53.01−$2.12
  6. Hanford, CA · California$53.01−$2.12
  7. Los Angeles, CA · California$55.62+$0.49

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

86078 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$53.01$40.20
Merced, CACalifornia$53.01$40.20
Modesto, CACalifornia$53.01$40.20
Napa, CACalifornia$58.61$43.20
Redding, CACalifornia$53.01$40.20
Rest of CaliforniaCalifornia$53.01$40.20
Riverside, CACalifornia$53.57$40.76
Sacramento, CACalifornia$54.87$41.28

86078 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$47.94

$67.29

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
86078 office rate range by state
State / territoryOffice rate rangeLocalities
AK$67.291
AL$48.331
AR$47.941
AZ$50.611
CA$53.01–$62.4629
CO$52.661
CT$53.871
DC$56.671
DE$51.191
FL$51.44–$54.773
GA$49.70–$52.172
GU$53.341
HI$53.341
IA$48.811
ID$49.031
IL$50.72–$53.914
IN$49.191
KS$48.781
KY$49.181
LA$49.18–$50.542
MA$52.60–$56.212
MD$51.84–$56.673
ME$49.28–$50.652
MI$50.00–$51.922
MN$50.811
MO$48.77–$50.533
MS$48.361
MT$51.431
NC$49.561
ND$50.451
NE$48.931
NH$52.011
NJ$54.58–$56.532
NM$50.191
NV$51.181
NY$49.99–$58.435
OH$49.791
OK$49.031
OR$50.87–$53.612
PA$49.78–$53.092
PR$51.621
RI$52.471
SC$49.741
SD$50.331
TN$48.931
TX$49.61–$52.418
UT$50.121
VA$50.62–$56.672
VI$51.621
VT$50.421
WA$52.45–$56.992
WI$49.481
WV$49.661
WY$51.001

See 86078 in every payment locality

How the 86078 rate is calculated

Each of 86078’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 · 86078

RVUs × geographic indexes × conversion factor

Office or facility?

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.

The exact Oxnard, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

10,600

Code
86078
Physician work
0.92
Practice expense
0.57
Malpractice
0.05

GPCI2026.csv

18

Locality
Oxnard, CA
Physician work
1.028
Practice expense
1.182
Malpractice
0.623
Office calculation for 86078 in Oxnard, CA
ComponentRVULocality factorAdjusted
Physician work0.92× 1.0280.9458
Practice expense0.57× 1.1820.6737
Malpractice0.05× 0.6230.0312
Total RVUs1.6506
Conversion factor× 33.4009

Office rate, Oxnard, CA$55.13

Office: (0.92 × 1.028 + 0.57 × 1.182 + 0.05 × 0.623) × $33.4009 = $55.13

Facility: (0.92 × 1.028 + 0.22 × 1.182 + 0.05 × 0.623) × $33.4009 = $41.32

Open 86078 in the RVU calculator

Payment rules and modifiers for 86078

86078 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 · 86078

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.

How 86078 has changed in Oxnard, CA

86078 · Office / nonfacility

$55.13

Effective 2026-10-01

The base rate is $0.13 higher than on 2025-10-01, moving from $55.00 to $55.13 (0.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $55.00changed to$55.13

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.94 changed to 0.92
    • Practice expense RVU 0.60 changed to 0.57
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.026 changed to 1.028
    • Practice expense GPCI 1.183 changed to 1.182
    • Malpractice GPCI 0.651 changed to 0.623

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $56.42changed to$55.00

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.59 changed to 0.60
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $55.50changed to$56.42

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $57.26changed to$55.50

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.027 changed to 1.026
    • Practice expense GPCI 1.181 changed to 1.183
    • Malpractice GPCI 0.689 changed to 0.651
  5. January 1, 2023

    RVU23A

    $57.51changed to$57.26

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.56 changed to 0.59
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 1.179 changed to 1.181
    • Malpractice GPCI 0.726 changed to 0.689

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $58.40changed to$57.51

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.57 changed to 0.56

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $60.30changed to$58.40

    • Conversion factor 36.0896 changed to 34.8931
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.178 changed to 1.179
    • Malpractice GPCI 0.700 changed to 0.726

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $60.48changed to$60.30

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.58 changed to 0.57
    • Work GPCI 1.024 changed to 1.026
    • Practice expense GPCI 1.176 changed to 1.178
    • Malpractice GPCI 0.673 changed to 0.700

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $61.69changed to$60.48

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.61 changed to 0.58

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $61.79changed to$61.69

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.027 changed to 1.024
    • Practice expense GPCI 1.178 changed to 1.176
    • Malpractice GPCI 0.754 changed to 0.673

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $61.51changed to$61.79

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.60 changed to 0.61
    • Work GPCI 1.030 changed to 1.027
    • Practice expense GPCI 1.180 changed to 1.178
    • Malpractice GPCI 0.834 changed to 0.754

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $60.88changed to$61.51

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.58 changed to 0.60

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $60.58changed to$60.88

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $59.00changed to$60.58

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.54 changed to 0.58
    • Work GPCI 1.032 changed to 1.030
    • Practice expense GPCI 1.187 changed to 1.180
    • Malpractice GPCI 0.720 changed to 0.834

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $58.05changed to$59.00

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.59 changed to 0.54
    • Work GPCI 1.034 changed to 1.032
    • Practice expense GPCI 1.193 changed to 1.187
    • Malpractice GPCI 0.605 changed to 0.720

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$58.05

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$55.13$41.32RVU26D
2026-07-01$55.13$41.32RVU26C
2026-04-01$55.13$41.32RVU26B
2026-01-01$55.13$41.32RVU26A
2025-10-01$55.00$49.64RVU25D
2025-07-01$55.00$49.64RVU25C
2025-04-01$55.00$49.64RVU25B
2025-01-01$55.00$49.64RVU25A
2024-10-01$56.42$50.91RVU24D
2024-07-01$56.42$50.91RVU24C
2024-04-01$56.42$50.91RVU24B
2024-03-09$56.42$50.91RVU24AR
2024-01-01$55.50$50.08RVU24A
2023-10-01$57.26$52.06RVU23D
2023-07-01$57.26$52.06RVU23C
2023-04-01$57.26$52.06RVU23B
2023-01-01$57.26$52.06RVU23A
2022-10-01$57.51$53.02RVU22D
2022-07-01$57.51$53.02RVU22C
2022-04-01$57.51$53.02RVU22B
2022-01-01$57.51$53.02RVU22A
2021-10-01$58.40$53.88RVU21D
2021-07-01$58.40$53.88RVU21C
2021-04-01$58.40$53.88RVU21B
2021-01-01$58.40$53.88RVU21A
2020-10-01$60.30$56.05RVU20D
2020-07-01$60.30$56.05RVU20C
2020-04-01$60.30$56.05RVU20B
2020-01-01$60.30$56.05RVU20A
2019-10-01$60.48$55.82RVU19D
2019-07-01$60.48$55.82RVU19C
2019-04-01$60.48$55.82RVU19B
2019-01-01$60.48$55.82RVU19A
2018-10-01$61.69$57.03RVU18D
2018-07-01$61.69$57.03RVU18C
2018-04-01$61.69$57.03RVU18B
2018-01-01$61.69$57.03RVU18AR1
2017-10-01$61.79$56.71RVU17D
2017-07-01$61.79$56.71RVU17C
2017-04-01$61.79$56.71RVU17B
2017-01-01$61.79$56.71RVU17A
2016-10-01$61.51$56.86RVU16D
2016-07-01$61.51$56.86RVU16C
2016-04-01$61.51$56.86RVU16B
2016-01-01$61.51$56.86RVU16A
2015-10-01$60.88$56.22RVU15D
2015-07-01$60.88$56.22RVU15C
2015-04-01$60.58$55.94RVU15B
2015-01-01$60.58$55.94RVU15A
2014-10-01$59.00$54.75RVU14D
2014-07-01$59.00$54.75RVU14C
2014-04-01$59.00$54.75RVU14B
2014-01-01$59.00$54.75RVU14A
2013-10-01$58.05$53.18RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 86078 for an earlier date of service

Where the Oxnard, CA rate applies

Oxnard, CA is a Medicare payment area, not a city. Our Census mapping connects it to 26 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Oxnard
  • Thousand Oaks
  • Bell Canyon
  • Camarillo
  • Casa Conejo
  • Channel Islands Beach
  • El Rio
  • Fillmore

Browse all communities in California

86078 billing questions

How is 86078 different from 86077?

86078 is for a physician’s investigation of a suspected transfusion reaction. 86077 concerns physician review of compatibility testing, not investigation of a reaction.

When should 86079 be reported instead?

86079 concerns a physician’s authorization to release blood or a blood product outside standard release procedures. It is not the code for evaluating a suspected transfusion reaction.

Does 86078 cover the laboratory tests in the reaction workup?

The code represents the physician’s investigation, not a count of laboratory assays. Report distinct tests, such as antibody screening or ABO typing, according to the services performed and documented.

What documentation supports reporting 86078?

Document the suspected transfusion reaction, the clinical and blood bank information reviewed, the physician’s conclusions, and any consultation or recommendations.

Is 86078 reported per test or per unit of blood?

The service is the physician’s investigation of the reaction, not each test result or each blood unit involved. The record should support the physician service reported.

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

Show the CMS file lines behind this rate
RVUs for 86078PPRRVU2026_Oct_nonQPP.csv, line 10,600 (RVU26D)
Geographic factors for Oxnard, CAGPCI2026.csv, line 18 (RVU26D)

Open CMS sourceHow we calculate rates

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