CPT code 86860: RBC antibody elution2026 Medicare rate & RVUs in Maryland
Reports laboratory removal of antibodies attached to red blood cells, usually to investigate a positive direct antiglobulin test or suspected immune hemolysis.
CMS doesn’t publish an office rate for 86860 in Maryland.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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.
Where 86860 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | Unavailable |
| Rest of Maryland | Unavailable | Unavailable |
| Washington, DC area | Unavailable | Unavailable |
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
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
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86860 isn’t priced in this setting.
86860 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 86880Direct CoombsEach antiserum
- Use 86880 for detecting antibody or complement attached to red cells. Use 86860 to remove attached antibodies for further study.
- 86870RBC antibody IDPer antibody panel
- Use 86870 for antibody identification. Use 86860 for the elution step that releases antibody from red cells.
- 86850Antibody screenRed blood cell antibodies
- Use 86850 to screen serum or plasma for RBC antibodies; 86860 concerns antibodies attached to the patient’s red cells.
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
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