86950 Leukacyte transfusion
What 86950 is
CMS fee schedule short descriptor: Leukacyte transfusion.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 86950 (CY2026)
This code has no Physician Fee Schedule rate: Statutory exclusion - not payable under the Physician Fee Schedule. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.
Medically Unlikely Edit (MUE)
Medicare caps 86950 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 86950? These codes are bundled into it
86950 is a Column 1 code in 5 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
36000 | Place needle in vein | 1 - modifier may bypass | Check pair |
36410 | Vnpnxr 3yr/> phy/qhp dx/ther | 1 - modifier may bypass | Check pair |
96360 | Hydration iv infusion init | 1 - modifier may bypass | Check pair |
96365 | Ther/proph/diag iv inf init | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
86950 is bundled into these codes
86950 appears as a Column 2 code in 5 active edits. Reported with one of these Column 1 codes on the same date of service, 86950 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
38228 | Car-t admn autologous | 0 | Check pair |
38240 | Transplt allo hct/donor | 0 | Check pair |
38241 | Transplt autol hct/donor | 1 | Check pair |
38242 | Transplt allo lymphocytes | 1 | Check pair |
38243 | Transplj hematopoietic boost | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.