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See a sample rate comparisonCPT 85018 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | QW - CLIA Waived Tests 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $2.37 national lab fee schedule rate (2026) · View Medicare rates for 85018 |
| Medicaid Fee Schedule | $2.18 median of the 8 states in the free preview · View Medicaid rates for 85018 |
National average reimbursement for CPT 85018 by major payers:
$2.29
$2.25
$3.14
$3.51
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CPT 85018
5 of 25 sample ratesHigher to lower in this preview
Hcn Ep Horizon City, LLC, The Hospitals Of Providence Emergency Room Montwood
Hcn Ep Horizon City LLC
$7.50Published rateChildren'S Hospital
Childrens Hospital Inc
$2.91Published rateHilton Head Health System, L.P., Hilton Head Hospital
$2.36Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Seneca
Prisma Health - Upstate
$2.13Published rateTimothy Lafont
Slocum Dickson Medical Group PLLC
$1.41Published rate
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See a sample payer proposalCPT 85018 vs. Other Hematology and Coagulation Procedures Codes
The CPT 85018 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 85018 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 |
|---|---|---|
| 84586-CPT | Low | Pancreas Islet Cell Tumor Test, The Test Identifies Secretions Of Vasoactive Intestinal Peptide (Vip) Which Can Cause Watery Diarrhea Low Potassium And Low Levels Of Stomach Acid. Vip Is Secreted By Tumors Of The Pancreas Islet Cells. |
| 85002-CPT | Low | Blood Clotting Test, Bleeding Time (Blood Clotting Test) Checks How Quickly The Blood Clots When A Small Skin Cut Is Made. The Test Is An Indicator Of Platelet Function (Platelets Are Blood Cells Required For Blood Clotting). |
| 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. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85018. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85018 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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Frequently Asked Questions
The CPT 85018 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 85018 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. For specific fee schedules based on CPT codes and your location, you can utilize Payerprice's lookup tool.