CPT 86905: Blood Group Antigen Typing (non-ABO, non-RhD)
Commercial payers pay $17 on average nationally for this procedure.
CPT code 86905 describes a laboratory blood typing test that identifies a patient’s non-ABO, non-RhD red blood cell antigen using serum as the specimen; this is a blood group antigen typing service typically performed in a clinical laboratory or hospital laboratory setting and is classified as a laboratory diagnostic test for transfusion support or antigen identification.
For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Antibody-Drug Conjugates, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only).
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National Reimbursement Benchmarks
Commercial reimbursement for CPT 86905 centers on a BUCA average of $16.7, while individual national payers diverge notably. Blue Cross Blue Shield posts the highest central tendency with a median of $26.3 and a mean of $26.5, Cigna and Aetna cluster at lower means ($4.5 and $2.9 respectively), and UnitedHealth Group sits near the lower-middle with a mean of $3.4. BUCA’s $16.7 average positions it between Blue Cross Blue Shield and the other national carriers, reflecting a mid-market commercial rate.
Dispersion (P75 minus P25) highlights where rates are tight or wide: Blue Cross Blue Shield’s dispersion is $14.9 ($33.8 - $19.9), BUCA’s interquartile spread is $8.8 ($21.1 - $12.3), Cigna’s spread is $3.1 ($5.6 - $2.5), UnitedHealth Group’s spread is $2.2 ($3.9 - $1.7), and Aetna’s is $1.2 ($3.2 - $2.0). Blue Cross Blue Shield exhibits the widest P25–P75 spread, while Aetna and UnitedHealth Group are the tightest among the listed payers.