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CPT 85025 Fee Schedule

Last Verified: January 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.

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$3.221629034905 - ANTHONY ABBRUZZI461939367 - ATLANTIC HOSPICE INCNJInternal Medicine Physician (207R00000X)
United
85025$4.651447427711 - SURESH KUMAR NAYUDU61081232 - (NY) MORRIS HEIGHTS HEALTH CENTER INCNYGastroenterology Physician (207RG0100X)
United
85025$4.671427348648 - RICARDO BADILLO752668018TXGastroenterology Physician (207RG0100X)
United
85025$4.551235199936 - MICHAEL WEISBERG752005254 - TEXAS DIGESTIVE DISEASE CONSULTANTSTXGastroenterology Physician (207RG0100X)
United
85025$2.601023087533 - ROBIN FEIGELIS223232829NJInternal Medicine Physician (207R00000X)
United
85025$3.531962548727 - FIDEL LIM223412735NJInternal Medicine Physician (207R00000X)
United
85025$3.531497785281 - MAGED BOUTROS273004281 - NEW JERSEY EYE INSTITUTE INCNJInternal Medicine Physician (207R00000X)
United
85025$9.231972536035 - SAURABH MEHANDRU611661781NYGastroenterology Physician (207RG0100X)
United
85025$3.731942287792 - CHE-NAN CHUANG264772401 - (NY) SANFORD ENDOSCOPY PLLCNYGastroenterology Physician (207RG0100X)
United
85025$3.781912938747 - RANA JAFRI522323973 - (NJ) MEDICAL ASSOCIATES OF MARLBORO PCNJInternal Medicine Physician (207R00000X)
United
85025$3.531366428567 - RAZIA AWAN43739843NJInternal Medicine Physician (207R00000X)
United
85025$8.801790770253 - ERIC ROSIER202088165 - ATLANTIC HEALTH SYSTEM INCNJInternal Medicine Physician (207R00000X)
United
85025$4.761174566699 - CHARLES SAHA852833791 - CHARLES SAHA MD PCNYGastroenterology Physician (207RG0100X)
United
85025$3.251235178799 - ORAL JAMES800400884 - (FL) NORTHWEST FLORIDA MULTISPECIALTY PHYSICIANS LLCTXGastroenterology Physician (207RG0100X)
United
85025$4.191922399070 - RACHEL SHUR853737205NJInternal Medicine Physician (207R00000X)
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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