Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 85013 Fee Schedule
Last Verified: September 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 85013 |
| Medicaid Fee Schedule | View Medicaid rates for 85013 |
National average reimbursement for CPT 85013 by major payers:
$6.06
$5.05
$5.86
$9.70
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 85013.
CPT 85013
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$15.40Published rateWillis Knighton Medical Center, Inc.
Willis-Knighton Medical Center
$7.00Published rateTenet Hospitals Limited, The Hospitals Of Providence East Campus
$7.00Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$3.99Published rateNevada Eye Care Professionals Little & Stein, Ltd.
Nevada Eye Care Professionals
$1.99Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 85013 vs. Other Hematology and Coagulation Procedures Codes
The CPT 85013 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 85013 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 |
|---|---|---|
| 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. |
| 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. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85013. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85013 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 85013) and we'll show you how you compare in 15 minutes or less.