CPT code 86880: Direct Coombs, each antiserum2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Detects antibodies or complement attached to a patient’s red blood cells, commonly during evaluation of hemolysis or a transfusion reaction.
Medicare pays $5.39 for 86880 under the 2026 Clinical Laboratory Fee Schedule: one national amount, the same in every state and setting.
Medicare lab fee · CLFS 2026 Q4
National CLFS amount
$5.39
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2020
- Unchanged
- CMS updates
- Quarterly
Medicare pays the lesser of the lab’s charge and this amount. Patients usually owe no Part B deductible or coinsurance for covered clinical lab tests.
On this page 8 sections
What 86880 covers
The direct antiglobulin test detects immunoglobulin or complement already attached to a patient’s red blood cells. Hospitals, reference laboratories, and transfusion services commonly perform it when investigating suspected immune-mediated hemolysis, a suspected transfusion reaction, or hemolytic disease in a newborn. The result helps determine whether red cells are coated; it does not identify the antibody’s specificity by itself.
Report 86880 for each antiserum tested. If additional testing is performed, select separate codes for distinct services, such as antibody identification or elution. Medicare pays this laboratory test through the CLFS. The 2026 national CLFS amount is $5.39, unchanged since 2020; the same amount applies across localities and settings, without a geographic or office/facility adjustment. The test is paid only from the CLFS, not the physician fee schedule.
This summary was written with AI assistance from CMS Clinical Laboratory Fee Schedule data. Amounts on this page come directly from CMS files.
How Medicare pays 86880
Clinical lab tests aren’t priced like physician services. They’re paid from their own fee schedule, with its own rules. See the whole lab fee schedule.
One national amount
CMS sets a single Clinical Laboratory Fee Schedule amount for 86880. There’s no geographic (GPCI) adjustment, so it pays the same in every state and payment locality.
No office or facility rate
Lab tests aren’t built from relative value units, so there’s no office and facility split: the place of service doesn’t change the CLFS amount.
Updated every quarter
CMS republishes the CLFS each quarter. New tests, often proprietary laboratory analyses (PLA codes), join during the year; existing amounts are updated each January.
Excluded from the physician fee schedule
The physician fee schedule lists 86880 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86880 on the lab fee schedule since 2020
86880 · CLFS 2026 Q4 (current)
$5.39
Unchanged since Jan 1, 2020
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
86880 compared with similar tests
- 86850Antibody screenRed blood cell antibodies$9.77
- Use 86850 to screen for red-cell antibodies in serum or plasma. Use 86880 to detect antibody or complement already attached to the patient’s red cells.
- 86885Indirect CoombsQualitative, each reagent cell$5.72
- 86885 is an indirect antiglobulin test reported qualitatively; 86880 is the direct test for red-cell-bound antibody or complement.
- 86870RBC antibody IDPer antibody panelNo national amount
- 86870 identifies the specificity of a red-cell antibody. 86880 detects red-cell coating but does not itself identify the antibody.
- 86860RBC antibody elutionNo national amount
- 86860 tests an eluate recovered from red cells to investigate attached antibody. 86880 detects whether antibody or complement is attached.
86880 billing questions
How is 86880 different from an indirect Coombs test?
86880 detects antibody or complement attached to the patient’s red cells. The indirect test evaluates antibodies in serum or plasma that can react with red cells.
How should units be counted?
Report one unit for each antiserum tested. Document the antiserum testing performed in the laboratory record.
Is antibody identification included in 86880?
No. Antibody identification is a distinct service, reported separately when performed; a positive direct antiglobulin result alone does not establish antibody specificity.
How does Medicare pay for 86880?
Medicare pays 86880 under the CLFS at one national amount, with no locality or office/facility adjustment. It is paid only through the CLFS.
Where this amount comes from
FeeBase reads lab amounts directly from the CMS Clinical Laboratory Fee Schedule file for the quarter: one row per code, with its payment indicator and national amount. Contractor-priced tests are labeled, never given a made-up amount. Amounts are Medicare payment limits, not a patient’s bill or a commercial rate.
CMS CLFS 2026 Q4 · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file line behind this amount
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