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See a sample rate comparisonCPT 85009 Fee Schedule
Medicare rates as of January 2026
CPT 85009 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
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 | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | TC - Technical component 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $5.07 national lab fee schedule rate (2026) · View Medicare rates for 85009 |
| Medicaid Fee Schedule | $4.665 median of the 8 states in the free preview · View Medicaid rates for 85009 |
National average reimbursement for CPT 85009 by major payers:
$4.30
BCBS / Anthem
$3.09
UnitedHealthcare
$5.24
Aetna
$7.15
Cigna
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CPT 85009
5 of 25 sample ratesHigher to lower in this preview
El Paso County Hospital District, University Medical Center Of El Paso
El Paso County Hospital District
$12.00Published rateChristopher Raio
Mercy Medical Center
$6.02Published rateColumbia Medical Center Of Arlington Subsidiary Lp, Medical City Arlington
Columbia Medical Center Of Arlington Subsidiary Lp
$5.07Published rateKell West Regional Hospital LLC
Kell West Regional Hospital, LLC
$4.71Published rateSt Davids Healthcare Partnership Lp LLP, Round Rock Medical Center
Lone Star Circle Of Care
$2.13Published rate
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See a sample payer proposalCPT 85009 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85009. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 85008-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. |
| 85009-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. |
| 85013-CPT | Low | Red Cell Volume (Hematocrit), The Hematocrit Test Looks At The Proportion Of Red Blood Cells As Part Of The Total Blood Volume. It Is Often Used To Detect Blood Loss Or Test For Iron Deficiency As Well As Other Conditions. |
| 85014-CPT | Low | Red Cell Volume (Hematocrit), The Hematocrit Test Looks At The Proportion Of Red Blood Cells As Part Of The Total Blood Volume. It Is Often Used To Detect Blood Loss Or Test For Iron Deficiency As Well As Other Conditions. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85009. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85009 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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