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CPT code 86860: RBC antibody elution2026 Medicare rate & RVUs in Madera, CA

Reports laboratory removal of antibodies attached to red blood cells, usually to investigate a positive direct antiglobulin test or suspected immune hemolysis.

CMS RVU26DEffective Oct 1, 2026One payment locality162 Medicare services in 2024

CMS doesn’t publish a rate for 86860 in Madera, CA.

Separate payment rules applyOffice (non-facility)
Separate payment rules applyHospital or facility

Check a contract rate as a % of Medicare · 86860 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 86860 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Madera, CA
  2. What 86860 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 86860 covers

An elution procedure separates antibodies coating a patient’s red blood cells so the recovered antibodies can be studied. Transfusion service and reference immunohematology laboratories typically perform it on a red-cell specimen during evaluation of a positive direct antiglobulin test, suspected transfusion-related hemolysis, or other immune destruction of red cells. The eluted material can help characterize the antibody involved; antibody identification is a distinct laboratory procedure.

Medicare assigns this CPT code status X: it is excluded from the physician fee schedule because it is not a physician service under the Medicare statute. When covered, payment is under another fee schedule or payment system. The code represents the elution procedure, not a quantity of antibody or a volume of specimen. Report it when the laboratory performs the elution, and distinguish that work from a direct antiglobulin test or subsequent antibody identification.

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 Madera, CA compares for 86860

86860 in Madera, CA vs other payment areas
  1. Madera, CA · this pageUnavailable
  2. Bakersfield, CA · CaliforniaUnavailable
  3. Chico, CA · CaliforniaUnavailable
  4. El Centro, CA · CaliforniaUnavailable
  5. Fresno, CA · CaliforniaUnavailable
  6. Hanford, CA · CaliforniaUnavailable
  7. Los Angeles, CA · CaliforniaUnavailable

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

Every other payment area

86860 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia——
Modesto, CACalifornia——
Napa, CACalifornia——
Oxnard, CACalifornia——
Redding, CACalifornia——
Rest of CaliforniaCalifornia——
Riverside, CACalifornia——
Sacramento, CACalifornia——

86860 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
86860 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 86860 in every payment locality

How the 86860 rate is calculated

Each of 86860’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 · 86860

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

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

Payment rules and modifiers for 86860

86860 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 · 86860

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

86860 isn’t priced in this setting.

Codes related to 86860

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

Codes related to 86860
CodeHow it relatesOffice range, Madera, CA
Often billed with
86880Direct Coombs, each antiserumDirect antiglobulin testing may prompt elution when red cells test positive.$5.39
86870RBC antibody ID, per antibody panelIdentifies red-cell antibodies after elution when that additional testing is performed.No office rate
86850Antibody screen, red blood cell antibodiesAn RBC antibody screen may be part of the same transfusion-related evaluation.$9.77

How 86860 has changed in Madera, CA

86860 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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. July 1, 2020

    RVU20C

    No ratechanged toNo rate

    Held through RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.

  2. April 1, 2020

    RVU20B

    No ratechanged toNo rate

  3. January 1, 2020

    RVU20A

    No ratechanged toNo rate

  4. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Separate payment rules applySeparate payment rules applyRVU26D
2026-07-01Separate payment rules applySeparate payment rules applyRVU26C
2026-04-01Separate payment rules applySeparate payment rules applyRVU26B
2026-01-01Separate payment rules applySeparate payment rules applyRVU26A
2025-10-01Separate payment rules applySeparate payment rules applyRVU25D
2025-07-01Separate payment rules applySeparate payment rules applyRVU25C
2025-04-01Separate payment rules applySeparate payment rules applyRVU25B
2025-01-01Separate payment rules applySeparate payment rules applyRVU25A
2024-10-01Separate payment rules applySeparate payment rules applyRVU24D
2024-07-01Separate payment rules applySeparate payment rules applyRVU24C
2024-04-01Separate payment rules applySeparate payment rules applyRVU24B
2024-03-09Separate payment rules applySeparate payment rules applyRVU24AR
2024-01-01Separate payment rules applySeparate payment rules applyRVU24A
2023-10-01Separate payment rules applySeparate payment rules applyRVU23D
2023-07-01Separate payment rules applySeparate payment rules applyRVU23C
2023-04-01Separate payment rules applySeparate payment rules applyRVU23B
2023-01-01Separate payment rules applySeparate payment rules applyRVU23A
2022-10-01Separate payment rules applySeparate payment rules applyRVU22D
2022-07-01Separate payment rules applySeparate payment rules applyRVU22C
2022-04-01Separate payment rules applySeparate payment rules applyRVU22B
2022-01-01Separate payment rules applySeparate payment rules applyRVU22A
2021-10-01Separate payment rules applySeparate payment rules applyRVU21D
2021-07-01Separate payment rules applySeparate payment rules applyRVU21C
2021-04-01Separate payment rules applySeparate payment rules applyRVU21B
2021-01-01Separate payment rules applySeparate payment rules applyRVU21A
2020-10-01Separate payment rules applySeparate payment rules applyRVU20D
2020-07-01Separate payment rules applySeparate payment rules applyRVU20C
2020-04-01Rate data unavailableRate data unavailableRVU20B
2020-01-01Separate payment rules applySeparate payment rules applyRVU20A
2019-10-01Rate data unavailableRate data unavailableRVU19D
2019-07-01Rate data unavailableRate data unavailableRVU19C
2019-04-01Rate data unavailableRate data unavailableRVU19B
2019-01-01Rate data unavailableRate data unavailableRVU19A
2018-10-01Rate data unavailableRate data unavailableRVU18D
2018-07-01Rate data unavailableRate data unavailableRVU18C
2018-04-01Rate data unavailableRate data unavailableRVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
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 86860 for an earlier date of service

Where the Madera, CA rate applies

Madera, CA is a Medicare payment area, not a city. Our Census mapping connects it to 17 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Madera
  • Ahwahnee
  • Bass Lake
  • Bonadelle Ranchos
  • Chowchilla
  • Coarsegold
  • Fairmead
  • La Vina

Browse all communities in California

86860 billing questions

When is elution different from a direct antiglobulin test?

A direct antiglobulin test, reported with 86880, detects antibody or complement attached to red cells. Elution removes attached antibodies for further study.

Does this code include antibody identification?

No. Elution releases antibody from red cells; 86870 describes antibody identification. Report the services performed according to applicable coding guidance.

What specimen is used?

The procedure uses the patient’s red blood cells, typically when investigating a positive direct antiglobulin test or suspected immune hemolysis.

Does Medicare pay this under the physician fee schedule?

No. Status X excludes the service from the physician fee schedule. When covered, it is paid under another fee schedule or payment system.

Is this the same as an RBC antibody screen?

No. Code 86850 screens for antibodies in the patient’s serum or plasma; 86860 removes antibodies already attached to red blood cells.

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

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