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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.

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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 codeShort descriptionModifier indicator
36000Place needle in vein1 - modifier may bypassCheck pair
36410Vnpnxr 3yr/> phy/qhp dx/ther1 - modifier may bypassCheck pair
96360Hydration iv infusion init1 - modifier may bypassCheck pair
96365Ther/proph/diag iv inf init1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck 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 codeShort descriptionModifier indicator
38228Car-t admn autologous0Check pair
38240Transplt allo hct/donor0Check pair
38241Transplt autol hct/donor1Check pair
38242Transplt allo lymphocytes1Check pair
38243Transplj hematopoietic boost1Check 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.