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

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 Queens, NY, Medicare pays $57.21 for 86079 in the office and $43.39 when it’s performed in a hospital or facility.

$57.21Office (non-facility)
$43.39Hospital or facility
+12.0%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $57.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

86079 in Queens, NY vs other payment areas
  1. Queens, NY · this page$57.21
  2. Manhattan, NY · New York$57.08−$0.13
  3. NYC suburbs and Long Island, NY · New York$58.04+$0.83
  4. Rest of New York · New York$49.67−$7.54
  5. Los Angeles, CA · California$55.23−$1.98
  6. Washington, DC area · District of Columbia$56.28−$0.93

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

Every other payment area

86079 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$54.42$42.25
Chicago, ILIllinois$53.57$41.83
AlaskaAlaska$66.93$54.48
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

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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 86079 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work0.92× 1.0640.9789
Practice expense0.56× 1.1820.6619
Malpractice0.05× 1.4420.0721
Total RVUs1.7129
Conversion factor× 33.4009

Office rate, Queens, NY$57.21

Office: (0.92 × 1.064 + 0.56 × 1.182 + 0.05 × 1.442) × $33.4009 = $57.21

Facility: (0.92 × 1.064 + 0.21 × 1.182 + 0.05 × 1.442) × $33.4009 = $43.39

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 Queens, NY

86079 · Office / nonfacility

$57.21

Effective 2026-10-01

The base rate is $0.13 higher than on 2025-10-01, moving from $57.08 to $57.21 (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

    $57.08changed to$57.21

    • 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
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $59.23changed to$57.08

    • 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

    $58.26changed to$59.23

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $61.23changed to$58.26

    • 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
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462
  5. January 1, 2023

    RVU23A

    $62.75changed to$61.23

    • 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
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $63.27changed to$62.75

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $65.04changed to$63.27

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.57 changed to 0.56
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $64.11changed to$65.04

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $65.34changed to$64.11

    • 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

    $65.19changed to$65.34

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $64.21changed to$65.19

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.58 changed to 0.60
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $63.15changed to$64.21

    • 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

    $62.83changed to$63.15

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $61.61changed to$62.83

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.53 changed to 0.55
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $60.08changed to$61.61

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.58 changed to 0.53
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $60.08

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$57.21$43.39RVU26D
2026-07-01$57.21$43.39RVU26C
2026-04-01$57.21$43.39RVU26B
2026-01-01$57.21$43.39RVU26A
2025-10-01$57.08$51.67RVU25D
2025-07-01$57.08$51.67RVU25C
2025-04-01$57.08$51.67RVU25B
2025-01-01$57.08$51.67RVU25A
2024-10-01$59.23$53.66RVU24D
2024-07-01$59.23$53.66RVU24C
2024-04-01$59.23$53.66RVU24B
2024-03-09$59.23$53.66RVU24AR
2024-01-01$58.26$52.78RVU24A
2023-10-01$61.23$55.89RVU23D
2023-07-01$61.23$55.89RVU23C
2023-04-01$61.23$55.89RVU23B
2023-01-01$61.23$55.89RVU23A
2022-10-01$62.75$58.08RVU22D
2022-07-01$62.75$58.08RVU22C
2022-04-01$62.75$58.08RVU22B
2022-01-01$62.75$58.08RVU22A
2021-10-01$63.27$58.56RVU21D
2021-07-01$63.27$58.56RVU21C
2021-04-01$63.27$58.56RVU21B
2021-01-01$63.27$58.56RVU21A
2020-10-01$65.04$60.22RVU20D
2020-07-01$65.04$60.22RVU20C
2020-04-01$65.04$60.22RVU20B
2020-01-01$65.04$60.22RVU20A
2019-10-01$64.11$59.79RVU19D
2019-07-01$64.11$59.79RVU19C
2019-04-01$64.11$59.79RVU19B
2019-01-01$64.11$59.79RVU19A
2018-10-01$65.34$60.58RVU18D
2018-07-01$65.34$60.58RVU18C
2018-04-01$65.34$60.58RVU18B
2018-01-01$65.34$60.58RVU18AR1
2017-10-01$65.19$60.45RVU17D
2017-07-01$65.19$60.45RVU17C
2017-04-01$65.19$60.45RVU17B
2017-01-01$65.19$60.45RVU17A
2016-10-01$64.21$59.49RVU16D
2016-07-01$64.21$59.49RVU16C
2016-04-01$64.21$59.49RVU16B
2016-01-01$64.21$59.49RVU16A
2015-10-01$63.15$58.84RVU15D
2015-07-01$63.15$58.84RVU15C
2015-04-01$62.83$58.55RVU15B
2015-01-01$62.83$58.55RVU15A
2014-10-01$61.61$56.89RVU14D
2014-07-01$61.61$56.89RVU14C
2014-04-01$61.61$56.89RVU14B
2014-01-01$61.61$56.89RVU14A
2013-10-01$60.08$55.61RVU13D
2013-07-01$60.08$55.61RVU13C
2013-04-01$60.08$55.61RVU13B
2013-01-01$60.08$55.61RVU13AR

Price 86079 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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