CPT code 86923: Electronic crossmatch, per donor unit2026 Medicare rate & RVUs in Guam
A blood bank reports an electronic compatibility check for each donor red blood cell unit evaluated for a patient before transfusion.
CMS doesn’t publish an office rate for 86923 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 86923 covers
An electronic crossmatch uses a computer-based comparison of the recipient’s blood bank information with a donor red blood cell unit to check compatibility before release for transfusion. A hospital transfusion service or reference laboratory typically performs and reports the test as part of pretransfusion testing. Unlike a serologic crossmatch, the compatibility check is electronic rather than a physical test mixing recipient serum or plasma with donor cells.
The code is reported for each donor unit checked. Medicare physician fee schedule status X means the service is excluded from payment under the physician fee schedule because it is not a physician service under the statute. When Medicare covers the service, payment is under another fee schedule or payment system. The physician fee schedule does not pay this 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.
86923 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | Unavailable |
How the 86923 rate is calculated
Each of 86923’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 · 86923
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 86923
86923 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 · 86923
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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86923 isn’t priced in this setting.
86923 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 86920Compatibility testImmediate spin, per unit
- Use 86920 for an immediate-spin serologic crossmatch. Use 86923 when the compatibility check is performed electronically.
- 86921Compatibility testIncubation technique
- Code 86921 describes a serologic compatibility test using incubation; 86923 describes an electronic compatibility check.
- 86922Antiglobulin crossmatchPer donor unit
- Code 86922 is the antiglobulin-method serologic crossmatch, while 86923 is the electronic method.
86923 billing questions
When should the electronic crossmatch be selected instead of a serologic crossmatch?
Use this code when compatibility is checked electronically. Codes 86920, 86921, and 86922 describe serologic crossmatch methods.
How many units should be reported?
Report one unit for each donor red blood cell unit checked electronically.
Does the electronic crossmatch involve physically mixing patient and donor samples?
No. This code describes a computer-based compatibility check, not a serologic test mixing recipient sample and donor cells.
Is this paid under the Medicare physician fee schedule?
No. Status X is a statutory exclusion from the physician fee schedule. When covered, Medicare pays it under another fee schedule or payment system.
How does this differ from code 86922?
Code 86922 is an antiglobulin-method serologic compatibility test. Code 86923 is the electronic method.
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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