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See a sample rate comparisonCPT 85013 Fee Schedule
Medicare rates as of January 2026
CPT 85013 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
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 | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $7.00 national lab fee schedule rate (2026) · View Medicare rates for 85013 |
| Medicaid Fee Schedule | $6.445 median of the 8 states in the free preview · View Medicaid rates for 85013 |
National average reimbursement for CPT 85013 by major payers:
$6.06
BCBS / Anthem
$5.05
UnitedHealthcare
$5.86
Aetna
$9.70
Cigna
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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
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See a sample payer proposalCPT 85013 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85013. Select one to see its fee schedule.
| 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.
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