CPT code 86870: RBC antibody ID, per antibody panel2026 Medicare rate & RVUs in Guam
Identifies red blood cell antibody specificity after a positive antibody screen, supporting transfusion planning and evaluation of clinically significant antibodies.
CMS doesn’t publish an office rate for 86870 in Guam.
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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On this page 9 sections
What 86870 covers
A transfusion-service or immunohematology laboratory uses a panel of reagent red cells to determine the specificity of an antibody detected in a patient’s sample. The test commonly follows a positive red blood cell antibody screen during pretransfusion testing or evaluation of red-cell alloantibodies. Hospital blood banks and reference laboratories perform this work as part of transfusion and immunohematology services.
Report one unit for each antibody identification panel performed. This differs from an antibody screen, which detects antibodies without determining their specificity, and from an antibody titer, which measures reaction strength; elution testing recovers antibody bound to red cells. Medicare assigns status X: this is not a physician service under the Medicare statute, so the physician fee schedule does not pay it. When covered, it is paid under another fee schedule or payment system.
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.
86870 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | Unavailable |
How the 86870 rate is calculated
Each of 86870’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 · 86870
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 86870
86870 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 · 86870
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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86870 isn’t priced in this setting.
86870 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 86850Antibody screenRed blood cell antibodies
- Use 86850 to detect whether red cell antibodies are present. Use 86870 to identify antibody specificity after detection.
- 86860RBC antibody elution
- 86860 recovers antibody bound to red cells; 86870 identifies antibody specificity using a panel of reagent red cells.
- 86886Antibody titerIndirect antiglobulin method
- 86886 reports an indirect antiglobulin antibody titer. It measures antibody reactivity rather than identifying its specificity.
86870 billing questions
How is 86870 different from 86850?
86850 screens for red cell antibodies; 86870 identifies their specificity. Both may be reported when the screen is positive and identification testing is performed.
What counts as one unit?
One unit represents one antibody identification panel. Report additional units for additional panels performed.
Is 86870 the same as an antibody titer?
No. Identification determines antibody specificity; a titer measures antibody reactivity through serial dilution and is reported with 86886 when that test is performed.
When is 86860 used instead?
86860 is for antibody elution testing, which recovers antibody bound to red cells. Elution and antibody identification may both be performed during an investigation of red-cell-bound antibodies.
How does Medicare treat this code?
Status X means the physician fee schedule does not pay 86870 because it is not a physician service under the Medicare statute. When covered, it is paid under another fee schedule or payment system.
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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