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

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 Vermont, Medicare pays $50.09 for 86079 in the office and $38.52 when it’s performed in a hospital or facility.

$50.09Office (non-facility)
$38.52Hospital or facility
−2.0%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 Vermont
  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 Vermont 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. Vermont pays $50.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

86079 in Vermont vs other payment areas
  1. Vermont · this page$50.09
  2. Los Angeles, CA · California$55.23+$5.14
  3. Washington, DC area · District of Columbia$56.28+$6.19
  4. Miami, FL · Florida$54.42+$4.33
  5. Chicago, IL · Illinois$53.57+$3.48
  6. Manhattan, NY · New York$57.08+$6.99
  7. Alaska · Alaska$66.93+$16.84

Other areas in Vermont 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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 86079 in Vermont
ComponentRVULocality factorAdjusted
Physician work0.92× 1.0000.9200
Practice expense0.56× 0.9900.5544
Malpractice0.05× 0.5060.0253
Total RVUs1.4997
Conversion factor× 33.4009

Office rate, Vermont$50.09

Office: (0.92 × 1 + 0.56 × 0.99 + 0.05 × 0.506) × $33.4009 = $50.09

Facility: (0.92 × 1 + 0.21 × 0.99 + 0.05 × 0.506) × $33.4009 = $38.52

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 Vermont

86079 · Office / nonfacility

$50.09

Effective 2026-10-01

The base rate is $0.06 higher than on 2025-10-01, moving from $50.03 to $50.09 (0.1%).

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

    $50.03changed to$50.09

    • 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 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $51.65changed to$50.03

    • 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

    $50.81changed to$51.65

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $52.86changed to$50.81

    • 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 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $52.91changed to$52.86

    • 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 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $53.35changed to$52.91

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $55.71changed to$53.35

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.57 changed to 0.56
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $55.80changed to$55.71

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $56.83changed to$55.80

    • 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

    $56.63changed to$56.83

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $55.73changed to$56.63

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.58 changed to 0.60
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $54.85changed to$55.73

    • 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

    $54.57changed to$54.85

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $53.88changed to$54.57

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.53 changed to 0.55
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$53.88

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$50.09$38.52RVU26D
2026-07-01$50.09$38.52RVU26C
2026-04-01$50.09$38.52RVU26B
2026-01-01$50.09$38.52RVU26A
2025-10-01$50.03$45.53RVU25D
2025-07-01$50.03$45.53RVU25C
2025-04-01$50.03$45.53RVU25B
2025-01-01$50.03$45.53RVU25A
2024-10-01$51.65$47.03RVU24D
2024-07-01$51.65$47.03RVU24C
2024-04-01$51.65$47.03RVU24B
2024-03-09$51.65$47.03RVU24AR
2024-01-01$50.81$46.26RVU24A
2023-10-01$52.86$48.47RVU23D
2023-07-01$52.86$48.47RVU23C
2023-04-01$52.86$48.47RVU23B
2023-01-01$52.86$48.47RVU23A
2022-10-01$52.91$49.10RVU22D
2022-07-01$52.91$49.10RVU22C
2022-04-01$52.91$49.10RVU22B
2022-01-01$52.91$49.10RVU22A
2021-10-01$53.35$49.51RVU21D
2021-07-01$53.35$49.51RVU21C
2021-04-01$53.35$49.51RVU21B
2021-01-01$53.35$49.51RVU21A
2020-10-01$55.71$51.71RVU20D
2020-07-01$55.71$51.71RVU20C
2020-04-01$55.71$51.71RVU20B
2020-01-01$55.71$51.71RVU20A
2019-10-01$55.80$52.14RVU19D
2019-07-01$55.80$52.14RVU19C
2019-04-01$55.80$52.14RVU19B
2019-01-01$55.80$52.14RVU19A
2018-10-01$56.83$52.82RVU18D
2018-07-01$56.83$52.82RVU18C
2018-04-01$56.83$52.82RVU18B
2018-01-01$56.83$52.82RVU18AR1
2017-10-01$56.63$52.64RVU17D
2017-07-01$56.63$52.64RVU17C
2017-04-01$56.63$52.64RVU17B
2017-01-01$56.63$52.64RVU17A
2016-10-01$55.73$51.77RVU16D
2016-07-01$55.73$51.77RVU16C
2016-04-01$55.73$51.77RVU16B
2016-01-01$55.73$51.77RVU16A
2015-10-01$54.85$51.24RVU15D
2015-07-01$54.85$51.24RVU15C
2015-04-01$54.57$50.98RVU15B
2015-01-01$54.57$50.98RVU15A
2014-10-01$53.88$49.92RVU14D
2014-07-01$53.88$49.92RVU14C
2014-04-01$53.88$49.92RVU14B
2014-01-01$53.88$49.92RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 86079 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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 VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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