CPT code 86079: Blood bank service, transfusion authorization2026 Medicare rate & RVUs in North Carolina

In North Carolina, Medicare pays $49.25 for 86079 in the office and $38.34 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 86079 nationwide

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

What 86079 covers

A transfusion medicine physician or blood bank pathologist uses this service to make and document a clinical decision authorizing release of blood or a blood component. It is associated with hospital transfusion-service work when the decision requires physician authorization, such as an urgent transfusion before compatibility testing is complete or a release decision involving an incompatible result. The code represents the physician’s authorization work, not the laboratory testing itself.

Report 86079 for the authorization decision rather than for compatibility testing, blood typing, or antibody screening. Documentation should identify the product under consideration, relevant test findings, the clinical reason for authorization, and the physician’s decision. CMS assigns physician work and practice expense to this service in the Physician Fee Schedule; the service should be supported by the physician’s documented blood bank work.

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 North Carolina compares for 86079

Across 109 of 109 payment localities, the office rate for 86079 runs from $47.66 in Arkansas to $66.93 in Alaska. North Carolina pays $49.25. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

86079 rates by state

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

See 86079 in every payment locality

How the 86079 rate is calculated

Each of 86079’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.

Payment rules and modifiers for 86079

86079 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.

Codes related to 86079

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 86079 has changed in North Carolina

Price 86079 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Advance
• Ahoskie
• Alamance
• Albemarle
• Alexis
• Alliance
• Altamahaw

Browse all communities in North Carolina

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

Open CMS sourceHow we calculate rates