CPT code 86079: Blood bank service, transfusion authorization2026 Medicare rate & RVUs in West Virginia
Reports a physician’s blood bank service when the physician reviews the circumstances and authorizes transfusion of a blood product or component.
In West Virginia, Medicare pays $49.37 for 86079 in the office and $39.21 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.
On this page 11 sections
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 West Virginia 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. West Virginia pays $49.37. The RVUs are the same everywhere; the geographic indexes change the dollars.
- West Virginia · this page$49.37
- Los Angeles, CA · California$55.23+$5.86
- Washington, DC area · District of Columbia$56.28+$6.91
- Miami, FL · Florida$54.42+$5.05
- Chicago, IL · Illinois$53.57+$4.20
- Manhattan, NY · New York$57.08+$7.71
- Alaska · Alaska$66.93+$17.56
Other areas in West Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $52.65 | $39.83 |
| Merced, CACalifornia | $52.65 | $39.83 |
| Modesto, CACalifornia | $52.65 | $39.83 |
| Napa, CACalifornia | $58.17 | $42.76 |
| Oxnard, CACalifornia | $54.74 | $40.92 |
| Redding, CACalifornia | $52.65 | $39.83 |
| Rest of CaliforniaCalifornia | $52.65 | $39.83 |
| Riverside, CACalifornia | $53.21 | $40.39 |
| Sacramento, CACalifornia | $54.48 | $40.89 |
| Salinas, CACalifornia | $54.26 | $40.71 |
| San Diego, CACalifornia | $54.93 | $40.94 |
| Marin County, CACalifornia | $60.79 | $44.30 |
| San Francisco, CACalifornia | $60.73 | $44.25 |
| San Benito County, CACalifornia | $61.98 | $45.12 |
| Santa Clara County, CACalifornia | $61.74 | $44.89 |
| San Luis Obispo, CACalifornia | $53.45 | $40.14 |
| Santa Cruz, CACalifornia | $55.00 | $40.79 |
| Santa Maria, CACalifornia | $54.29 | $40.66 |
| Santa Rosa, CACalifornia | $55.51 | $41.16 |
| Stockton, CACalifornia | $52.65 | $39.83 |
| Vallejo, CACalifornia | $58.08 | $42.68 |
| Visalia, CACalifornia | $52.65 | $39.83 |
| Yuba City, CACalifornia | $52.65 | $39.83 |
| ColoradoColorado | $52.30 | $39.86 |
| ConnecticutConnecticut | $53.51 | $40.92 |
| DelawareDelaware | $50.86 | $39.31 |
| Fort Lauderdale, FLFlorida | $52.70 | $40.85 |
| Rest of FloridaFlorida | $51.12 | $39.94 |
| Atlanta, GAGeorgia | $51.83 | $39.95 |
| Rest of GeorgiaGeorgia | $49.40 | $38.98 |
| Hawaii, Guam, HIHawaii | $52.96 | $39.67 |
| IowaIowa | $48.51 | $37.81 |
| IdahoIdaho | $48.73 | $37.97 |
| East St. Louis, ILIllinois | $51.30 | $40.55 |
| Rest of IllinoisIllinois | $50.42 | $39.74 |
| Suburban Chicago, ILIllinois | $53.11 | $41.11 |
| IndianaIndiana | $48.88 | $38.04 |
| KansasKansas | $48.48 | $37.91 |
| KentuckyKentucky | $48.89 | $38.49 |
| New Orleans, LALouisiana | $50.23 | $39.23 |
| Rest of LouisianaLouisiana | $48.88 | $38.54 |
| Metropolitan Boston, MAMassachusetts | $55.81 | $41.85 |
| Rest of MassachusettsMassachusetts | $52.25 | $39.94 |
| Baltimore area, MDMaryland | $53.36 | $40.81 |
| Rest of MarylandMaryland | $51.50 | $39.67 |
| Rest of MaineMaine | $48.98 | $38.22 |
| Southern Maine, MEMaine | $50.32 | $38.73 |
| Detroit, MIMichigan | $51.59 | $40.31 |
| Rest of MichiganMichigan | $49.69 | $39.02 |
| MinnesotaMinnesota | $50.47 | $38.44 |
| Metropolitan Kansas City, MOMissouri | $49.92 | $38.95 |
| Metropolitan St. Louis, MOMissouri | $50.21 | $39.08 |
| Rest of MissouriMissouri | $48.48 | $38.40 |
| MississippiMississippi | $48.07 | $38.00 |
| MontanaMontana | $51.10 | $39.41 |
| North CarolinaNorth Carolina | $49.25 | $38.34 |
| North DakotaNorth Dakota | $50.11 | $38.42 |
| NebraskaNebraska | $48.62 | $37.83 |
| New HampshireNew Hampshire | $51.66 | $39.49 |
| Northern New JerseyNew Jersey | $56.15 | $42.58 |
| Rest of New JerseyNew Jersey | $54.22 | $41.45 |
| New MexicoNew Mexico | $49.89 | $39.17 |
| NevadaNevada | $50.84 | $39.14 |
| NYC suburbs and Long Island, NYNew York | $58.04 | $44.14 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $54.61 | $41.81 |
| Queens, NYNew York | $57.21 | $43.39 |
| Rest of New YorkNew York | $49.67 | $38.57 |
| OhioOhio | $49.49 | $38.82 |
| OklahomaOklahoma | $48.73 | $38.29 |
| Portland, OROregon | $53.24 | $40.26 |
| Rest of OregonOregon | $50.53 | $38.89 |
| Metropolitan Philadelphia, PAPennsylvania | $52.75 | $40.58 |
| Rest of PennsylvaniaPennsylvania | $49.48 | $38.75 |
| Puerto RicoPuerto Rico | $51.28 | $39.47 |
| Rhode IslandRhode Island | $52.12 | $40.05 |
| South CarolinaSouth Carolina | $49.43 | $38.63 |
| South DakotaSouth Dakota | $49.99 | $38.30 |
| TennesseeTennessee | $48.63 | $38.00 |
| Austin, TXTexas | $52.06 | $39.69 |
| Beaumont, TXTexas | $49.30 | $38.66 |
| Brazoria, TXTexas | $50.81 | $39.23 |
| Dallas, TXTexas | $51.07 | $39.42 |
| Fort Worth, TXTexas | $50.90 | $39.38 |
| Galveston, TXTexas | $50.93 | $39.32 |
| Houston, TXTexas | $51.85 | $40.24 |
| Rest of TexasTexas | $49.99 | $38.89 |
| UtahUtah | $49.81 | $38.82 |
| VirginiaVirginia | $50.29 | $38.80 |
| Virgin Islands, VIUnited States Virgin Islands | $51.28 | $39.47 |
| VermontVermont | $50.09 | $38.52 |
| Rest of WashingtonWashington | $52.10 | $39.79 |
| King County, WAWashington | $56.58 | $42.24 |
| WisconsinWisconsin | $49.16 | $37.96 |
| WyomingWyoming | $50.67 | $38.98 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $66.93 | 1 |
| AL | $48.04 | 1 |
| AR | $47.66 | 1 |
| AZ | $50.28 | 1 |
| CA | $52.65–$61.98 | 29 |
| CO | $52.30 | 1 |
| CT | $53.51 | 1 |
| DC | $56.28 | 1 |
| DE | $50.86 | 1 |
| FL | $51.12–$54.42 | 3 |
| GA | $49.40–$51.83 | 2 |
| GU | $52.96 | 1 |
| HI | $52.96 | 1 |
| IA | $48.51 | 1 |
| ID | $48.73 | 1 |
| IL | $50.42–$53.57 | 4 |
| IN | $48.88 | 1 |
| KS | $48.48 | 1 |
| KY | $48.89 | 1 |
| LA | $48.88–$50.23 | 2 |
| MA | $52.25–$55.81 | 2 |
| MD | $51.50–$56.28 | 3 |
| ME | $48.98–$50.32 | 2 |
| MI | $49.69–$51.59 | 2 |
| MN | $50.47 | 1 |
| MO | $48.48–$50.21 | 3 |
| MS | $48.07 | 1 |
| MT | $51.10 | 1 |
| NC | $49.25 | 1 |
| ND | $50.11 | 1 |
| NE | $48.62 | 1 |
| NH | $51.66 | 1 |
| NJ | $54.22–$56.15 | 2 |
| NM | $49.89 | 1 |
| NV | $50.84 | 1 |
| NY | $49.67–$58.04 | 5 |
| OH | $49.49 | 1 |
| OK | $48.73 | 1 |
| OR | $50.53–$53.24 | 2 |
| PA | $49.48–$52.75 | 2 |
| PR | $51.28 | 1 |
| RI | $52.12 | 1 |
| SC | $49.43 | 1 |
| SD | $49.99 | 1 |
| TN | $48.63 | 1 |
| TX | $49.30–$52.06 | 8 |
| UT | $49.81 | 1 |
| VA | $50.29–$56.28 | 2 |
| VI | $51.28 | 1 |
| VT | $50.09 | 1 |
| WA | $52.10–$56.58 | 2 |
| WI | $49.16 | 1 |
| WV | $49.37 | 1 |
| WY | $50.67 | 1 |
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
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 West Virginia 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
110
- Locality
- West Virginia
- Physician work
- 1.000
- Practice expense
- 0.869
- Malpractice
- 1.431
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.92 | × 1.000 | 0.9200 |
| Practice expense | 0.56 | × 0.869 | 0.4866 |
| Malpractice | 0.05 | × 1.431 | 0.0716 |
| Total RVUs | 1.4782 | ||
| Conversion factor | × 33.4009 | ||
Office rate, West Virginia$49.37
Office: (0.92 × 1 + 0.56 × 0.869 + 0.05 × 1.431) × $33.4009 = $49.37
Facility: (0.92 × 1 + 0.21 × 0.869 + 0.05 × 1.431) × $33.4009 = $39.21
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 West Virginia
86079 · Office / nonfacility
$49.37
Effective 2026-10-01
The base rate is $0.79 higher than on 2025-10-01, moving from $48.58 to $49.37 (1.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$48.58changed to$49.37
- 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 0.862 changed to 0.869
- Malpractice GPCI 1.333 changed to 1.431
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$50.44changed to$48.58
- Conversion factor 33.2875 changed to 32.3465
- Malpractice RVU 0.05 changed to 0.04
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$49.61changed to$50.44
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$51.06changed to$49.61
- 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 0.860 changed to 0.862
- Malpractice GPCI 1.266 changed to 1.333
January 1, 2023
RVU23A
$51.23changed to$51.06
- 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 0.858 changed to 0.860
- Malpractice GPCI 1.198 changed to 1.266
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$51.66changed to$51.23
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$53.80changed to$51.66
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.57 changed to 0.56
- Practice expense GPCI 0.857 changed to 0.858
- Malpractice GPCI 1.247 changed to 1.198
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$53.82changed to$53.80
- Conversion factor 36.0391 changed to 36.0896
- Malpractice GPCI 1.296 changed to 1.247
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$54.68changed to$53.82
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.60 changed to 0.57
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$54.29changed to$54.68
- Conversion factor 35.8887 changed to 35.9996
- Practice expense GPCI 0.847 changed to 0.857
- Malpractice GPCI 1.289 changed to 1.296
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$53.31changed to$54.29
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.58 changed to 0.60
- Practice expense GPCI 0.836 changed to 0.847
- Malpractice GPCI 1.282 changed to 1.289
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$52.60changed to$53.31
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 0.55 changed to 0.58
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$52.34changed to$52.60
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$51.72changed to$52.34
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.53 changed to 0.55
- Practice expense GPCI 0.832 changed to 0.836
- Malpractice GPCI 1.256 changed to 1.282
Held through RVU15B.
January 1, 2014
RVU14A
$50.41changed to$51.72
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.58 changed to 0.53
- Practice expense GPCI 0.828 changed to 0.832
- Malpractice GPCI 1.229 changed to 1.256
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $50.41
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $49.37 | $39.21 | RVU26D |
| 2026-07-01 | $49.37 | $39.21 | RVU26C |
| 2026-04-01 | $49.37 | $39.21 | RVU26B |
| 2026-01-01 | $49.37 | $39.21 | RVU26A |
| 2025-10-01 | $48.58 | $44.68 | RVU25D |
| 2025-07-01 | $48.58 | $44.68 | RVU25C |
| 2025-04-01 | $48.58 | $44.68 | RVU25B |
| 2025-01-01 | $48.58 | $44.68 | RVU25A |
| 2024-10-01 | $50.44 | $46.42 | RVU24D |
| 2024-07-01 | $50.44 | $46.42 | RVU24C |
| 2024-04-01 | $50.44 | $46.42 | RVU24B |
| 2024-03-09 | $50.44 | $46.42 | RVU24AR |
| 2024-01-01 | $49.61 | $45.66 | RVU24A |
| 2023-10-01 | $51.06 | $47.27 | RVU23D |
| 2023-07-01 | $51.06 | $47.27 | RVU23C |
| 2023-04-01 | $51.06 | $47.27 | RVU23B |
| 2023-01-01 | $51.06 | $47.27 | RVU23A |
| 2022-10-01 | $51.23 | $47.96 | RVU22D |
| 2022-07-01 | $51.23 | $47.96 | RVU22C |
| 2022-04-01 | $51.23 | $47.96 | RVU22B |
| 2022-01-01 | $51.23 | $47.96 | RVU22A |
| 2021-10-01 | $51.66 | $48.36 | RVU21D |
| 2021-07-01 | $51.66 | $48.36 | RVU21C |
| 2021-04-01 | $51.66 | $48.36 | RVU21B |
| 2021-01-01 | $51.66 | $48.36 | RVU21A |
| 2020-10-01 | $53.80 | $50.40 | RVU20D |
| 2020-07-01 | $53.80 | $50.40 | RVU20C |
| 2020-04-01 | $53.80 | $50.40 | RVU20B |
| 2020-01-01 | $53.80 | $50.40 | RVU20A |
| 2019-10-01 | $53.82 | $50.73 | RVU19D |
| 2019-07-01 | $53.82 | $50.73 | RVU19C |
| 2019-04-01 | $53.82 | $50.73 | RVU19B |
| 2019-01-01 | $53.82 | $50.73 | RVU19A |
| 2018-10-01 | $54.68 | $51.29 | RVU18D |
| 2018-07-01 | $54.68 | $51.29 | RVU18C |
| 2018-04-01 | $54.68 | $51.29 | RVU18B |
| 2018-01-01 | $54.68 | $51.29 | RVU18AR1 |
| 2017-10-01 | $54.29 | $50.94 | RVU17D |
| 2017-07-01 | $54.29 | $50.94 | RVU17C |
| 2017-04-01 | $54.29 | $50.94 | RVU17B |
| 2017-01-01 | $54.29 | $50.94 | RVU17A |
| 2016-10-01 | $53.31 | $50.02 | RVU16D |
| 2016-07-01 | $53.31 | $50.02 | RVU16C |
| 2016-04-01 | $53.31 | $50.02 | RVU16B |
| 2016-01-01 | $53.31 | $50.02 | RVU16A |
| 2015-10-01 | $52.60 | $49.60 | RVU15D |
| 2015-07-01 | $52.60 | $49.60 | RVU15C |
| 2015-04-01 | $52.34 | $49.35 | RVU15B |
| 2015-01-01 | $52.34 | $49.35 | RVU15A |
| 2014-10-01 | $51.72 | $48.44 | RVU14D |
| 2014-07-01 | $51.72 | $48.44 | RVU14C |
| 2014-04-01 | $51.72 | $48.44 | RVU14B |
| 2014-01-01 | $51.72 | $48.44 | RVU14A |
| 2013-10-01 | $50.41 | $47.31 | RVU13D |
| 2013-07-01 | $50.41 | $47.31 | RVU13C |
| 2013-04-01 | $50.41 | $47.31 | RVU13B |
| 2013-01-01 | $50.41 | $47.31 | RVU13AR |
Where the West Virginia rate applies
West Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 439 cities and communities in West Virginia. Some span more than one payment area; confirm with the service ZIP.
- Accoville
- Addison (Webster Springs)
- Adrian
- Albright
- Alderson
- Alum Creek
- Amherstdale
- Anawalt
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
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