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CPT 85041 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.

Red Cell Count
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Hematology and Coagulation Procedures

Common Place of Service

81 - Independent Laboratory

21 - Inpatient Hospital

Common Modifiers

None

26 - Professional component

90 - Reference Laboratory

Complexity LevelLow
Medicare Fee ScheduleView Medicare rates for 85041

National average reimbursement for CPT 85041 by major payers:

bcbs

$2.72

uhc

$2.13

aetna

$3.42

cigna

$4.46

Preview provider-level rates for...
For billing codeCPT 85041
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 85041

United
85041$3.011811942238 - KPH-CONSOLIDATION, INC., HCA HOUSTON HEALTHCARE NORTH CYPRESS A CAMPUS OF HCA HOUSTON HEALTHCAR621619857TXGeneral Acute Care Hospital (282N00000X)
United
85041$3.011629021845 - ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP, NORTH AUSTIN MEDICAL CENTER742781812TXGeneral Acute Care Hospital (282N00000X)
United
85041$2.581013068808 - ST HELENA PARISH HOSPITAL, ST HELENA PARISH HOSPITAL720627145 - (LA) ST HELENA PARISH HOSPITALLACritical Access Hospital (282NC0060X)
United
85041$7.501225381197 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL HAUSMAN452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLCTXGeneral Acute Care Hospital (282N00000X)
United
85041$3.011639422504 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL SCHERTZ452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLCTXGeneral Acute Care Hospital (282N00000X)
United
85041$4.191174572416 - DALLAS VAMC756108647TXGeneral Acute Care Hospital (282N00000X)
United
85041$3.011144203662 - TOPS SPECIALTY HOSPITAL, LTD., TOPS SURGICAL SPECIALTY HOSPITAL760246499 - (TX) TOPS SPECIALTY HOSPITAL LTDTXGeneral Acute Care Hospital (282N00000X)
United
85041$7.501154618742 - VHS HARLINGEN HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER452662980TXGeneral Acute Care Hospital (282N00000X)
United
85041$4.191225087794 - AMARILLO VAMC751616212TXGeneral Acute Care Hospital (282N00000X)
United
85041$3.011407364847 - TYLER REGIONAL HOSPITAL LLC823878395TXGeneral Acute Care Hospital (282N00000X)
United
85041$3.771396394961 - CLHG-ACADIAN, LLC, ACADIAN MEDICAL CENTER825359949LAGeneral Acute Care Hospital (282N00000X)
United
85041$3.011609275585 - CHCA PEARLAND, L.P., HCA HOUSTON HEALTHCARE PEARLAND50631189TXGeneral Acute Care Hospital (282N00000X)
United
85041$1.751801893417 - SMITHVILLE HOSPITAL AUTHORITY, SMITHVILLE REGIONAL HOSPITAL741706734TXGeneral Acute Care Hospital (282N00000X)
United
85041$7.501861994808 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE NORTHEAST CAMPUS813935393 - (TX) HCN EP HORIZON CITY LLCTXGeneral Acute Care Hospital (282N00000X)
United
85041$3.011699726406 - COLUMBIA MEDICAL CENTER OF PLANO SUBSIDIARY LP, MEDICAL CITY PLANO621682203TXGeneral Acute Care Hospital (282N00000X)
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 85041 vs. Other Hematology and Coagulation Procedures Codes

The CPT 85041 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 85041 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
85008-CPTLowBlood Ct Man Smear Exam Wo Diff Par
85009-CPTLowBlood Cnt;Diff.Wbc Count,Buffy Coat
85013-CPTLowBlood Ct Spun Microhematocrit
85041-CPTLowRed 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 85041. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 85041 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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