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

Reports a physician’s blood bank service when the physician reviews the circumstances and authorizes transfusion of a blood product or component.

CMS RVU26DEffective Oct 1, 2026One payment locality4.8K Medicare services in 2024

In Nebraska, Medicare pays $48.62 for 86079 in the office and $37.83 when it’s performed in a hospital or facility.

$48.62Office (non-facility)
$37.83Hospital or facility
−4.9%vs the national office rate ($51.10)

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.

We’ll open 86079 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nebraska
  2. What 86079 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 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 Nebraska 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. Nebraska pays $48.62. The RVUs are the same everywhere; the geographic indexes change the dollars.

86079 in Nebraska vs other payment areas
  1. Nebraska · this page$48.62
  2. Los Angeles, CA · California$55.23+$6.61
  3. Washington, DC area · District of Columbia$56.28+$7.66
  4. Miami, FL · Florida$54.42+$5.80
  5. Chicago, IL · Illinois$53.57+$4.95
  6. Manhattan, NY · New York$57.08+$8.46
  7. Alaska · Alaska$66.93+$18.31

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

Every other payment area

86079 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$48.04$37.81
ArkansasArkansas$47.66$37.61
ArizonaArizona$50.28$38.96
Bakersfield, CACalifornia$52.83$40.02
Chico, CACalifornia$52.65$39.83
El Centro, CACalifornia$52.65$39.84
Fresno, CACalifornia$52.65$39.83
Hanford, CACalifornia$52.65$39.83

86079 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.

$47.66

$66.93

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

View every state and territory as a table
86079 office rate range by state
State / territoryOffice rate rangeLocalities
AK$66.931
AL$48.041
AR$47.661
AZ$50.281
CA$52.65–$61.9829
CO$52.301
CT$53.511
DC$56.281
DE$50.861
FL$51.12–$54.423
GA$49.40–$51.832
GU$52.961
HI$52.961
IA$48.511
ID$48.731
IL$50.42–$53.574
IN$48.881
KS$48.481
KY$48.891
LA$48.88–$50.232
MA$52.25–$55.812
MD$51.50–$56.283
ME$48.98–$50.322
MI$49.69–$51.592
MN$50.471
MO$48.48–$50.213
MS$48.071
MT$51.101
NC$49.251
ND$50.111
NE$48.621
NH$51.661
NJ$54.22–$56.152
NM$49.891
NV$50.841
NY$49.67–$58.045
OH$49.491
OK$48.731
OR$50.53–$53.242
PA$49.48–$52.752
PR$51.281
RI$52.121
SC$49.431
SD$49.991
TN$48.631
TX$49.30–$52.068
UT$49.811
VA$50.29–$56.282
VI$51.281
VT$50.091
WA$52.10–$56.582
WI$49.161
WV$49.371
WY$50.671

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.

How the rate is built · 86079

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.92

0.92 RVUs× 1.000 GPCI

Practice expense0.56

0.56 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

1.5300

Conversion factor

$33.4009

Medicare rate

$51.10

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Nebraska inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

10,601

Code
86079
Physician work
0.92
Practice expense
0.56
Malpractice
0.05

GPCI2026.csv

72

Locality
Nebraska
Physician work
1.000
Practice expense
0.923
Malpractice
0.378
Office calculation for 86079 in Nebraska
ComponentRVULocality factorAdjusted
Physician work0.92× 1.0000.9200
Practice expense0.56× 0.9230.5169
Malpractice0.05× 0.3780.0189
Total RVUs1.4558
Conversion factor× 33.4009

Office rate, Nebraska$48.62

Office: (0.92 × 1 + 0.56 × 0.923 + 0.05 × 0.378) × $33.4009 = $48.62

Facility: (0.92 × 1 + 0.21 × 0.923 + 0.05 × 0.378) × $33.4009 = $37.83

Open 86079 in the RVU calculator

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.

Place of service · 86079

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$51.10

Non-facility (office)
$51.10
Facility
$39.41

Higher because the practice carries its own overhead.

How 86079 has changed in Nebraska

86079 · Office / nonfacility

$48.62

Effective 2026-10-01

The base rate is $0.32 higher than on 2025-10-01, moving from $48.30 to $48.62 (0.7%).

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

    $48.30changed to$48.62

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.94 changed to 0.92
    • Practice expense RVU 0.59 changed to 0.56
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.917 changed to 0.923
    • Malpractice GPCI 0.304 changed to 0.378

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $49.81changed to$48.30

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $48.99changed to$49.81

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $50.78changed to$48.99

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.60 changed to 0.59
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.913 changed to 0.917
    • Malpractice GPCI 0.269 changed to 0.304
  5. January 1, 2023

    RVU23A

    $50.53changed to$50.78

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.56 changed to 0.60
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.235 changed to 0.269

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $50.95changed to$50.53

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $53.12changed to$50.95

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.57 changed to 0.56
    • Practice expense GPCI 0.909 changed to 0.908
    • Malpractice GPCI 0.277 changed to 0.235

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $53.14changed to$53.12

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 0.910 changed to 0.909
    • Malpractice GPCI 0.318 changed to 0.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $54.07changed to$53.14

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.60 changed to 0.57

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $53.92changed to$54.07

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.909 changed to 0.910
    • Malpractice GPCI 0.340 changed to 0.318

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $53.16changed to$53.92

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.58 changed to 0.60
    • Practice expense GPCI 0.908 changed to 0.909
    • Malpractice GPCI 0.362 changed to 0.340

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $52.37changed to$53.16

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.55 changed to 0.58

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $52.11changed to$52.37

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $51.49changed to$52.11

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.53 changed to 0.55
    • Practice expense GPCI 0.906 changed to 0.908
    • Malpractice GPCI 0.342 changed to 0.362

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $50.37changed to$51.49

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.58 changed to 0.53
    • Practice expense GPCI 0.904 changed to 0.906
    • Malpractice GPCI 0.322 changed to 0.342

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $50.37

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$48.62$37.83RVU26D
2026-07-01$48.62$37.83RVU26C
2026-04-01$48.62$37.83RVU26B
2026-01-01$48.62$37.83RVU26A
2025-10-01$48.30$44.15RVU25D
2025-07-01$48.30$44.15RVU25C
2025-04-01$48.30$44.15RVU25B
2025-01-01$48.30$44.15RVU25A
2024-10-01$49.81$45.53RVU24D
2024-07-01$49.81$45.53RVU24C
2024-04-01$49.81$45.53RVU24B
2024-03-09$49.81$45.53RVU24AR
2024-01-01$48.99$44.79RVU24A
2023-10-01$50.78$46.76RVU23D
2023-07-01$50.78$46.76RVU23C
2023-04-01$50.78$46.76RVU23B
2023-01-01$50.78$46.76RVU23A
2022-10-01$50.53$47.08RVU22D
2022-07-01$50.53$47.08RVU22C
2022-04-01$50.53$47.08RVU22B
2022-01-01$50.53$47.08RVU22A
2021-10-01$50.95$47.47RVU21D
2021-07-01$50.95$47.47RVU21C
2021-04-01$50.95$47.47RVU21B
2021-01-01$50.95$47.47RVU21A
2020-10-01$53.12$49.51RVU20D
2020-07-01$53.12$49.51RVU20C
2020-04-01$53.12$49.51RVU20B
2020-01-01$53.12$49.51RVU20A
2019-10-01$53.14$49.86RVU19D
2019-07-01$53.14$49.86RVU19C
2019-04-01$53.14$49.86RVU19B
2019-01-01$53.14$49.86RVU19A
2018-10-01$54.07$50.46RVU18D
2018-07-01$54.07$50.46RVU18C
2018-04-01$54.07$50.46RVU18B
2018-01-01$54.07$50.46RVU18AR1
2017-10-01$53.92$50.33RVU17D
2017-07-01$53.92$50.33RVU17C
2017-04-01$53.92$50.33RVU17B
2017-01-01$53.92$50.33RVU17A
2016-10-01$53.16$49.58RVU16D
2016-07-01$53.16$49.58RVU16C
2016-04-01$53.16$49.58RVU16B
2016-01-01$53.16$49.58RVU16A
2015-10-01$52.37$49.11RVU15D
2015-07-01$52.37$49.11RVU15C
2015-04-01$52.11$48.87RVU15B
2015-01-01$52.11$48.87RVU15A
2014-10-01$51.49$47.92RVU14D
2014-07-01$51.49$47.92RVU14C
2014-04-01$51.49$47.92RVU14B
2014-01-01$51.49$47.92RVU14A
2013-10-01$50.37$46.99RVU13D
2013-07-01$50.37$46.99RVU13C
2013-04-01$50.37$46.99RVU13B
2013-01-01$50.37$46.99RVU13AR

Price 86079 for an earlier date of service

Where the Nebraska rate applies

Nebraska is a Medicare payment area, not a city. Our Census mapping connects it to 593 cities and communities in Nebraska. Some span more than one payment area; confirm with the service ZIP.

  • Abie
  • Adams
  • Agnew
  • Ainsworth
  • Albion
  • Alda
  • Alexandria
  • Allen

Browse all communities in Nebraska

86079 billing questions

When should 86079 be chosen over 86077?

Use 86079 for physician authorization of a blood or blood-component transfusion. Code 86077 represents a different physician blood bank service involving compatibility testing and unusual antibody review.

Does 86079 report the crossmatch or antibody screen?

No. It reports the physician’s authorization decision, not the laboratory crossmatch or antibody-screen testing; those services have their own codes when performed and reportable.

What documentation supports 86079?

Record the blood product being considered, pertinent compatibility findings, why physician authorization was needed, and the physician’s decision to authorize transfusion.

Is 86079 the code for investigating a transfusion reaction?

No. Investigation of a transfusion reaction is represented by 86078; 86079 concerns authorization for transfusion of blood or a blood component.

Who typically performs the service?

A physician working with the hospital blood bank, commonly a transfusion medicine physician or blood bank pathologist, makes and documents the authorization decision.

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 86079PPRRVU2026_Oct_nonQPP.csv, line 10,601 (RVU26D)
Geographic factors for NebraskaGPCI2026.csv, line 72 (RVU26D)

Open CMS sourceHow we calculate rates

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