CPT 86850: Screening Test for Non‑A/B Red Blood Cell Antibodies
Commercial payers pay $22 on average nationally for this procedure.
CPT code 86850 describes a laboratory screening test for unexpected antibodies to red blood cells (RBCs) using a patient’s blood specimen; this is a blood bank/serology service performed by a clinical laboratory or hospital blood bank to detect non‑A and non‑B RBC antibodies prior to transfusion or as part of immunohematology evaluation, typically provided in an outpatient laboratory, hospital lab, or transfusion service setting.
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National Reimbursement Benchmarks
Commercial reimbursement for CPT 86850 centers on BUCA as the average commercial benchmark at $21.9, with payer-specific distributions showing meaningful variation. Blue Cross Blue Shield (BCBS) and Aetna demonstrate higher median and mean positions versus Cigna and UnitedHealth Group: BCBS mean is $30.7 with median $29.6, Aetna mean $11.3 with median $8, Cigna mean $10.2 median $8.7, and UnitedHealth Group mean $8.7 median $5.9. BUCA’s average sits between the higher BCBS cluster and the lower UnitedHealth Group/Cigna cluster, offering a mid-market reference at $21.9.
Dispersion (P75 minus P25) highlights differences in rate concentration across payers: Blue Cross Blue Shield has a spread of $13.5 ($37.8 - $22.5), the widest among listed payers; Aetna’s spread is $7.4 ($13.4 - $6.0); Cigna’s spread is $7.9 ($12.9 - $5.0); UnitedHealth Group is the tightest with a spread of $5.8 ($9.9 - $4.1). These ranges indicate BCBS has the greatest variability while UnitedHealth Group shows the most compressed commercial rates around its central tendency.