RxDoctor Payments Data

CPT 86900

Blood group typing (abo)

$2.92Medicare-allowed amount per service, averaged across 56,439 services
Providers submitted
$36.25

Asking price, not received

Medicare allowed
$2.92

The fee schedule figure

Medicare paid
$2.92

Balance is patient coinsurance

Providers submitted an average of $36.25 for this code and Medicare allowed $2.9212.4× 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 $2.92 (100%); the rest is the patient’s coinsurance and deductible.

Services
56,439

Medicare Part B, 2024

Beneficiaries
46,111
Providers billing it
171
Total allowed
$164,802

Services × allowed amount

What Medicare pays for CPT 86900

Across 56,439 services billed by 171 providers to 46,111 beneficiaries, Medicare allowed an average of $2.92 per service. That is 1.2 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 86900

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory56,00945,732$2.93158
Pathology144114$2.875
Internal Medicine8886$2.442
Physician Assistant7669$2.932
Interventional Cardiology6764$2.932
Gastroenterology3934$1.371
Family Practice1612$2.931

86900 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
Florida7,960$2.92$2.939
New Jersey7,218$2.93$2.9312
California7,076$2.94$2.9324
Minnesota5,011$2.93$2.939
North Carolina2,973$2.93$2.934
Virginia2,973$2.92$2.934
Texas2,766$2.93$2.9310
Wisconsin2,671$2.92$2.944
Ohio2,507$2.92$2.938
New York2,005$2.92$2.937
Pennsylvania1,932$2.93$2.938
Maryland1,743$2.91$2.937
Arizona1,218$2.93$2.933
Illinois798$2.85$2.934
Kansas778$2.93$2.933
Oklahoma771$2.91$2.933
Hawaii719$2.92$2.932
Maine693$2.93$2.931
Alabama619$2.93$2.931
Massachusetts520$2.93$2.933
Michigan445$2.93$2.936
Tennessee429$2.92$2.934
Washington371$2.92$2.933
Connecticut302$2.93$2.931
Nevada289$2.93$2.932
Colorado267$2.93$2.931
Louisiana222$2.93$2.934
Mississippi221$2.92$2.933
New Mexico219$2.93$2.931
Iowa163$2.92$2.934
Oregon106$2.93$2.933
Indiana95$2.93$2.931
North Dakota63$2.85$2.931
Puerto Rico57$2.84$2.932
Georgia54$2.93$2.931
Nebraska39$2.93$2.931
Utah39$2.93$2.931
Kentucky27$2.93$2.931
Rhode Island21$2.93$2.931
U.S. Virgin Islands18$2.93$2.931
Idaho17$2.93$2.931
South Dakota13$2.93$2.931
South Carolina11$2.93$2.931

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.