CPT code 86920: Compatibility test, immediate spin, per unit2026 Medicare rate & RVUs in Guam
Reports a rapid immediate-spin compatibility check between a recipient’s blood and a selected donor blood unit before transfusion.
CMS doesn’t publish an office rate for 86920 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 86920 covers
A transfusion service or blood bank performs this rapid serologic check to assess compatibility between a recipient’s blood and a selected donor blood unit. It is part of pretransfusion testing and helps identify incompatibility, particularly involving ABO blood groups. The code distinguishes the immediate-spin method from crossmatches that use incubation, antiglobulin testing, or electronic methods.
Report one unit for each blood unit tested by the immediate-spin method. This service is distinct from blood typing and antibody testing, which may be performed as part of the same pretransfusion workup and reported separately when appropriate. Medicare assigns status X: the test is not a physician service under the Medicare statute, so the physician fee schedule does not pay it. When Medicare covers it, payment is 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.
86920 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | Unavailable |
How the 86920 rate is calculated
Each of 86920’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 · 86920
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 86920
86920 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 · 86920
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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86920 isn’t priced in this setting.
86920 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 86921Compatibility testIncubation technique
- Use 86921 when the compatibility test uses incubation; use 86920 for the immediate-spin method.
- 86922Antiglobulin crossmatchPer donor unit
- Use 86922 for an antiglobulin compatibility test. Code 86920 identifies the immediate-spin method.
- 86923Electronic crossmatchPer donor unit
- Use 86923 for electronic compatibility testing; 86920 is for a serologic immediate-spin check.
- 86900ABO typingSerologic blood group
- Code 86900 reports ABO blood typing, not compatibility testing between a recipient and a selected donor unit.
86920 billing questions
When is the immediate-spin method distinguished from other compatibility tests?
Use this code for a compatibility check performed by the immediate-spin method. Incubation, antiglobulin, and electronic methods have separate codes.
How many units should be reported?
Report one unit for each blood unit tested by this method.
Does this code include blood typing or antibody testing?
It represents the compatibility check, not blood typing or antibody testing. Those are distinct services when performed and reported separately.
What documentation supports reporting this service?
Document the immediate-spin compatibility testing performed and the number of blood units tested.
How does Medicare treat this code?
Status X means the physician fee schedule does not pay it 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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