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CPT 85025 Fee Schedule

Last Verified: November 2025

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.

Complete Blood Cell Count (Red Cells, White Blood Cell, Platelets), Automated Test And Automated Differential White Blood Cell Count
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Hematology and Coagulation Procedures

Common Place of Service

81 - Independent Laboratory

11 - Office

Common Modifiers

None

26 - Professional component

QW - CLIA Waived Tests

Complexity LevelLow

National average reimbursement for CPT 85025 by major payers:

bcbs

$7.25

uhc

$5.58

aetna

$9.94

cigna

$11.67

Preview provider-level rates for...
For billing codeCPT 85025
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 85025

United
85025$3.501831531995 - ANIQA KOHEN161460136 - (NY) GENERAL PHYSICIAN, P.C.SCGastroenterology Physician (207RG0100X)
United
85025$6.631821472663 - HAMZEH SARAIREH43286529 - (MA) PRIMA CARE, P.C.VAGastroenterology Physician (207RG0100X)
United
85025$4.551235199936 - MICHAEL WEISBERG752005254 - TEXAS DIGESTIVE DISEASE CONSULTANTSTXGastroenterology Physician (207RG0100X)
United
85025$3.251235121732 - DANIEL CAMARA160743187 - (NY) SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORKNYGastroenterology Physician (207RG0100X)
United
85025$3.251356397400 - MAHESH KRISHNAIAH57842177NYGastroenterology Physician (207RG0100X)
United
85025$6.031831519495 - FIRAS AL-ANI593214635 - FLORIDA HOSPITAL MEDICAL GROUP INCFLGastroenterology Physician (207RG0100X)
United
85025$12.861669645222 - MAISA ABDALLA160743209 - UNIVERSITY OF ROCHESTERCAGastroenterology Physician (207RG0100X)
United
85025$3.251235178799 - ORAL JAMES800400884 - (FL) NORTHWEST FLORIDA MULTISPECIALTY PHYSICIANS LLCTXGastroenterology Physician (207RG0100X)
United
85025$14.761083971782 - RITA KNOTTS135562308 - NEW YORK UNIVERSITYNYGastroenterology Physician (207RG0100X)
United
85025$9.281043416407 - KUNWARDEEP SOHAL461322238NYGastroenterology Physician (207RG0100X)
United
85025$8.631558360172 - ROBERT PFEFFER135562308 - NEW YORK UNIVERSITYNYGastroenterology Physician (207RG0100X)
United
85025$6.301336339464 - IVONNE RAMIREZ205842775NYGastroenterology Physician (207RG0100X)
United
85025$4.651285601419 - RICHARD FAZIO133642414 - (NY) RICHARD A. FAZIO, M.D., P.C.NYGastroenterology Physician (207RG0100X)
United
85025$3.741285601419 - RICHARD FAZIO263381883 - AMBOY MEDICAL PRACTICE PCNYGastroenterology Physician (207RG0100X)
United
85025$16.181982652319 - CHARLES WIDESKA135562308 - NEW YORK UNIVERSITYNYGastroenterology Physician (207RG0100X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 85025 vs. Other Hematology and Coagulation Procedures Codes

The CPT 85025 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 85025 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.

CodeComplexityDescription
85002-CPTLowBleeding Time
85004-CPTLowBlood Count; Automated Differential Wbc Count
85018-CPTLowHgb Hemoglobin
85025-CPTLowComplete Blood Cell Count (Red Cells, White Blood Cell, Platelets), Automated Test And Automated Differential White Blood Cell Count

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85025. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 85025 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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