CPT code 86078: Blood bank service, transfusion reaction investigation2026 Medicare rate & RVUs in Elgin, Texas
CPT 86078: $50.30–$52.41 office ($39.21–$40.04 facility) across 2 localities in Elgin, TX in 2026 Medicare. Compare each area.
Medicare pays $50.30–$52.41 for 86078 in the office in Elgin, Texas, from Rest of Texas to Austin, TX. 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.
On this page 6 sections
Where 86078 pays more and less in Elgin, Texas
Elgin, Texas maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $52.41 | $40.04 |
| Rest of Texas | $50.30 | $39.21 |
How payment areas work in Elgin
City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.
- Rest Of State · Bastrop County
- Austin · Travis County
City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions
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
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 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.
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
Fee sheets · Coming soon
Put 86078 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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