CPT 86901: Rh Blood Group Serologic Typing, Serum/Plasma
Commercial payers pay $11 on average nationally for this procedure.
CPT code 86901 describes a serologic test performed by a laboratory analyst to determine a patient’s blood type within the Rh blood group system using serum or plasma; this is a blood typing service typically performed in a clinical laboratory or hospital laboratory setting for transfusion compatibility and diagnostic purposes.
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National Reimbursement Benchmarks
Commercial reimbursement for CPT 86901 centers around BUCA’s average commercial rate of $10.5, with notable variation across major national payers. Blue Cross Blue Shield shows the highest central tendency (median $15.1) and a wide upper bound (90th percentile $23.0), while Aetna and Cigna present much lower central values (medians $2.3 and $3.3 respectively). Cigna’s maximum is $13.1 and UnitedHealth Group’s median is $1.8, reflecting differing network pricing strategies.
Examining dispersion (P75 minus P25) highlights where rates cluster or diverge: Blue Cross Blue Shield has the widest interquartile spread at $7.0 ($19.2 − $12.2), indicating more variability in contracted rates, while UnitedHealth Group is the tightest at $1.7 ($3.0 − $1.3). Aetna’s spread is $1.7 ($3.7 − $2.0) and Cigna’s is $3.0 ($5.0 − $2.0), placing them between the extremes. BUCA’s quartiles (P75 $12.7, P25 $7.8) imply a moderate spread of $4.9 without min/max reporting.