RxDoctor Payments Data

CPT 86880

Red blood cell antibody detection test, direct

$5.28Medicare-allowed amount per service, averaged across 34,637 services
Providers submitted
$40.98

Asking price, not received

Medicare allowed
$5.28

The fee schedule figure

Medicare paid
$5.28

Balance is patient coinsurance

Providers submitted an average of $40.98 for this code and Medicare allowed $5.287.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $5.28 (100%); the rest is the patient’s coinsurance and deductible.

Services
34,637

Medicare Part B, 2024

Beneficiaries
27,388
Providers billing it
98
Total allowed
$182,883

Services × allowed amount

What Medicare pays for CPT 86880

Across 34,637 services billed by 98 providers to 27,388 beneficiaries, Medicare allowed an average of $5.28 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 86880

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory34,44727,213$5.2893
Cardiology8482$5.281
Hematology-Oncology7668$5.283
Pathology3025$5.281

86880 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
New Jersey9,493$5.27$5.283
Florida5,398$5.28$5.284
Texas4,016$5.28$5.286
North Carolina3,349$5.29$5.294
California2,401$5.28$5.2817
Arizona1,382$5.28$5.283
Kansas1,038$5.28$5.283
New York966$5.27$5.283
Ohio829$5.28$5.283
Alabama592$5.28$5.282
Illinois557$5.28$5.282
Tennessee546$5.26$5.282
Maryland501$5.36$5.284
Pennsylvania469$5.25$5.285
Minnesota395$5.28$5.282
Massachusetts393$5.28$5.282
Washington389$5.28$5.283
Oklahoma305$5.27$5.283
Nevada289$5.28$5.282
Wisconsin256$5.26$5.282
Hawaii249$5.26$5.282
Virginia167$5.26$5.283
New Mexico111$5.28$5.281
Iowa97$5.28$5.283
Maine91$5.28$5.281
Colorado82$5.28$5.281
Connecticut54$5.28$5.281
Michigan49$5.19$5.281
Oregon43$5.28$5.282
Indiana33$5.28$5.282
South Dakota18$5.28$5.281
Rhode Island18$5.28$5.281
Utah17$5.28$5.281
Louisiana16$5.28$5.281
Georgia15$5.28$5.281
Puerto Rico13$4.99$5.281

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.