CPT code 86921: Compatibility test, incubation technique2026 Medicare rate & RVUs in Missouri
Reports an incubated serologic crossmatch to assess compatibility between a recipient’s blood sample and a donor red blood cell unit before transfusion.
CMS doesn’t publish an office rate for 86921 in Missouri.
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 86921 covers
This serologic crossmatch checks compatibility between a recipient’s serum or plasma and red blood cells from a specific donor unit. The blood bank incubates the sample and donor cells as part of the compatibility assessment before transfusion. Blood bank technologists in hospital transfusion services or reference laboratories typically perform the test, with the laboratory reporting the procedure for each donor unit tested.
Medicare assigns this code physician fee schedule status X, a statutory exclusion because the service is not a physician service under the Medicare statute. When covered, payment is under another applicable fee schedule or payment system, not the physician fee schedule. Status X describes physician fee schedule treatment; it is not itself a coverage determination. Distinguish this method from an immediate-spin, antiglobulin, or electronic compatibility test, which has a separate code.
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 86921 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
How the 86921 rate is calculated
Each of 86921’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 · 86921
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 86921
86921 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 · 86921
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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86921 isn’t priced in this setting.
86921 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 86920Compatibility testImmediate spin, per unit
- Choose 86920 for an immediate-spin crossmatch; choose 86921 when the compatibility test uses incubation.
- 86922Antiglobulin crossmatchPer donor unit
- 86922 identifies the antiglobulin technique, while 86921 identifies the incubation technique.
- 86923Electronic crossmatchPer donor unit
- 86923 is for an electronic compatibility test; 86921 is for a serologic test using incubation.
86921 billing questions
How does this differ from 86920?
86921 identifies an incubation technique. 86920 identifies an immediate-spin compatibility test.
How many units should be reported?
Report the test for each donor red blood cell unit tested for compatibility.
Does Medicare pay this under the physician fee schedule?
No. Medicare assigns status X, a statutory exclusion from physician fee schedule payment; when covered, payment is under another applicable fee schedule or payment system.
When should 86922 be used instead?
Use 86922 for a compatibility test performed by the antiglobulin technique, rather than the incubation technique identified by 86921.
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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