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CPT 85041 Fee Schedule

Last Verified: December 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.

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

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$1.801548260482 - MAIN LINE PATHOLOGY ASSOCIATES, PC232786651 - (PA) MAIN LINE PATHOLOGY ASSOCIATES, P.CPAClinical Pathology/Laboratory Medicine Physician (207ZP0105X)
United
85041$1.801548260482 - MAIN LINE PATHOLOGY ASSOCIATES, PC232786651 - (PA) MAIN LINE PATHOLOGY ASSOCIATES, P.CPAClinical Pathology/Laboratory Medicine Physician (207ZP0105X)
United
85041$3.011538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS954537720TXGeneral Acute Care Hospital (282N00000X)
United
85041$3.011417471467 - WEATHERFORD HEALTH SERVICES, LLC, MEDICAL CITY WEATHERFORD822073410 - (TX) WEATHERFORD HEALTH SERVICES LLCTXGeneral Acute Care Hospital (282N00000X)
United
85041$1.751144227935 - CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE, TRINITY MEDICAL720578642 - (LA) RIVERLAND MEDICAL CENTERLACritical Access Hospital (282NC0060X)
United
85041$3.611609971019 - SCURRY COUNTY HOSPITAL DISTRICT, COGDELL MEMORIAL HOSPITAL752403687 - (TX) SCURRY COUNTY HOSPITAL DISTRICTTXGeneral Acute Care Hospital (282N00000X)
United
85041$3.011396520862 - LAKE SURGICAL HOSPITAL SLIDELL, LLC474228147 - (LA) LAKE SURGICAL HOSPITAL SLIDELL, LLC DBA SOUTHERN SURGICAL HOSPITALLAGeneral Acute Care Hospital (282N00000X)
United
85041$3.011932204427 - NMC OPERATING COMPANY LLC, THE SPINE HOSPITAL OF LOUISIANA270059959 - (LA) NMC OPERATING COMPANY, LLCLAGeneral Acute Care Hospital (282N00000X)
United
85041$1.731851390967 - UHS OF TEXOMA, INC, TEXOMA MEDICAL CENTER205908627 - UHS OF TEXOMA INCTXGeneral Acute Care Hospital (282N00000X)
United
85041$3.011841237807 - CHCA MAINLAND, L.P., MAINLAND MEDICAL CENTER621801360TXGeneral Acute Care Hospital (282N00000X)
United
85041$3.011841844735 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL KELLY452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLCTXGeneral Acute Care Hospital (282N00000X)
United
85041$3.011831975572 - DECATUR HEALTH SERVICES, LLC932081386TXGeneral Acute Care Hospital (282N00000X)
United
85041$1.751235177320 - BIENVILLE MEDICAL CENTER, INC.743227578LACritical Access Hospital (282NC0060X)
United
85041$1.751801893417 - SMITHVILLE HOSPITAL AUTHORITY, SMITHVILLE REGIONAL HOSPITAL741706734TXGeneral Acute Care Hospital (282N00000X)
United
85041$3.771396394961 - CLHG-ACADIAN, LLC, ACADIAN MEDICAL CENTER825359949LAGeneral 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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