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See a sample rate comparisonCPT 85007 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Manual Blood Count, Routine Blood Test Where A Sample Is Examined Under A Microscope. The Basic Components Are Counted: White Blood Cells (Wbcs) Red Blood Cells And Platelets. The Five Wbc Types Also May Be Counted: Neutrophils Lymphocytes Monocytes Eosinophils Basophils.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 21 - Inpatient Hospital 81 - Independent Laboratory |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $3.80 national lab fee schedule rate (2026) · View Medicare rates for 85007 |
| Medicaid Fee Schedule | $3.50 median of the 8 states in the free preview · View Medicaid rates for 85007 |
National average reimbursement for CPT 85007 by major payers:
$3.29
$2.57
$4.43
$5.95
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CPT 85007
5 of 25 sample ratesHigher to lower in this preview
Ashraf Aly
Slocum Dickson Medical Group PLLC
$4.36Published rateBonnie Casanova
Slocum Dickson Medical Group PLLC
$3.16Published rateDaniel Grace
Slocum Dickson Medical Group PLLC
$3.16Published rateMohsin Syed
Slocum Dickson Medical Group PLLC
$1.60Published rateJohn Ellis
Slocum Dickson Medical Group PLLC
$1.60Published rate
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See a sample payer proposalCPT 85007 vs. Other Hematology and Coagulation Procedures Codes
The CPT 85007 code is part of the Pathology and Laboratory Procedures services used for Hematology and Coagulation Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 85007 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 85004-CPT | Low | Automated Count Of Blood Cells, Machine Blood Count Measuring The Number Of White Cells (Wbcs) Red Cells (Rbcs) And Platelets. |
| 85007-CPT | Low | Manual Blood Count, Routine Blood Test Where A Sample Is Examined Under A Microscope. The Basic Components Are Counted: White Blood Cells (Wbcs) Red Blood Cells And Platelets. The Five Wbc Types Also May Be Counted: Neutrophils Lymphocytes Monocytes Eosinophils Basophils. |
| 85018-CPT | Low | Hemoglobin Count, The Hemoglobin Count Helps To Evaluate The Amount Of Iron In The Blood. It Can Be Done As Part Of A Complete Blood Count (Cbc). A Low Count Can Be An Indicator Of Anemia. |
| 85025-CPT | Low | Complete Blood Count (Cbc), A Complete Blood Count Includes Red Blood Cells White Blood Cells Hemoglobin Hematocrit Platelets And Distribution Of The Cells Within The Blood Volume Sampled. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85007. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85007 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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