$48.77–$50.53
Choose 86078 when the physician investigates a suspected transfusion reaction; 86077 describes physician review of compatibility testing.
On this page
CMS RVU26D · Effective 2026-10-01
86078 Blood bank service Medicare reimbursement rates in Missouri
A physician investigates a suspected transfusion reaction by evaluating the clinical event and relevant blood bank findings to help determine its cause. Compare 86078 office and facility rates across CMS payment localities in Missouri.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 86078 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$48.77–$50.53
3 of 3 localities have a supported rate.
Facility setting
$38.69–$39.40
3 of 3 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 86078 pays more and less in Missouri
3 payment localities
$48.77 to $50.53
Transfusion medicine
About 86078: Physician transfusion reaction investigation
A physician investigates a suspected transfusion reaction by evaluating the clinical event and relevant blood bank findings to help determine its cause.
This service covers a physician’s investigation of a suspected reaction occurring during or after a blood transfusion. A transfusion medicine physician or pathologist typically reviews the patient’s clinical course and blood bank findings, such as compatibility testing and reaction-workup results, and may discuss the findings with the treating team. The investigation supports decisions about the reaction’s cause and the patient’s transfusion care in a hospital or blood bank setting.
Report 86078 for the physician’s reaction investigation, rather than for an individual laboratory assay or simply because a transfusion reaction workup was ordered. Documentation should identify the suspected reaction, the records and test results reviewed, the physician’s assessment, and any consultation or recommendations. Distinct laboratory tests performed during the workup are reported according to the services actually performed. CMS physician fee schedule values for this code reflect physician work and practice expense; the supplied CMS facts list no additional payment rules for it.
Where the value comes from
- Work RVU0.92 · 60%
- Practice expense (office) RVU0.57 · 37%
- Malpractice RVU0.05 · 3%
6.7K
Medicare services in 2024 · #1690 by national volume
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.
86078 compared with similar codes
Office rates for Missouri, from the same CMS release.
$48.48–$50.21
Choose 86079 for physician authorization to release blood outside standard procedures. Use 86078 for a physician’s reaction investigation.
86850
No office rateRbc antibody screen
86850 reports an antibody screening test. It does not represent the physician’s assessment of a suspected transfusion reaction.
Compare 86078 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
$50.24
Facility
$39.26
Metropolitan St. Louis →
Office / nonfacility
$50.53
Facility
$39.40
Rest Of Missouri →
Office / nonfacility
$48.77
Facility
$38.69
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86078 billing questions
How is 86078 different from 86077?
86078 is for a physician’s investigation of a suspected transfusion reaction. 86077 concerns physician review of compatibility testing, not investigation of a reaction.
When should 86079 be reported instead?
86079 concerns a physician’s authorization to release blood or a blood product outside standard release procedures. It is not the code for evaluating a suspected transfusion reaction.
Does 86078 cover the laboratory tests in the reaction workup?
The code represents the physician’s investigation, not a count of laboratory assays. Report distinct tests, such as antibody screening or ABO typing, according to the services performed and documented.
What documentation supports reporting 86078?
Document the suspected transfusion reaction, the clinical and blood bank information reviewed, the physician’s conclusions, and any consultation or recommendations.
Is 86078 reported per test or per unit of blood?
The service is the physician’s investigation of the reaction, not each test result or each blood unit involved. The record should support the physician service reported.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
10,59786060,,Antistreptolysin o titer,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10,59886063,,Antistreptolysin o screen,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10,59986077,,Phys blood bank serv xmatch,A,,0.92,0.57,,0.22,,0.05,1.54,1.19,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10,60086078,,Phys blood bank serv reactj,A,,0.92,0.57,,0.22,,0.05,1.54,1.19,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10,60186079,,Phys blood bank serv authrj,A,,0.92,0.56,,0.21,,0.05,1.53,1.18,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10,60286140,,C-reactive protein,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10,60386141,,C-reactive protein hs,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00