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CPT 85244 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.

Clotting;Factor Viii Relate Antigen Quan
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Hematology and Coagulation Procedures

Common Place of Service

81 - Independent Laboratory

49 - Independent Clinic

Common Modifiers

None

26 - Professional component

90 - Reference Laboratory

Complexity LevelLow

National average reimbursement for CPT 85244 by major payers:

bcbs

$18.54

uhc

$14.54

aetna

$23.95

cigna

$31.05

Preview provider-level rates for...
For billing codeCPT 85244
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 85244

United
85244$20.651952309171 - BAYCARE HOME CARE, INC.593582520 - (FL) BAYCARE HOME CARE INCFLHome Health Agency (251E00000X)
United
85244$55.001801164967 - DA PEDIATRIC REHABILITATION270939565 - (FL) DA PEDIATRIC REHABILITATIONFLHome Health Agency (251E00000X)
United
85244$55.001801164967 - DA PEDIATRIC REHABILITATION270939565 - (FL) DA PEDIATRIC REHABILITATIONFLHome Health Agency (251E00000X)
United
85244$20.651972501252 - BAYCARE HOME CARE, INC.593582520 - (FL) BAYCARE HOME CARE INCFLHome Health Agency (251E00000X)
United
85244$20.651821097627 - BAYCARE HOME CARE, INC.593582520 - (FL) BAYCARE HOME CARE INCFLHome Health Agency (251E00000X)
United
85244$11.761609823194 - SACRED HEART HEALTH SYSTEM INC, SACRED HEART HOME CARE590634434 - SACRED HEART HEALTH SYSTEM INCFLHome Health Agency (251E00000X)
United
85244$40.001801164967 - DA PEDIATRIC REHABILITATION270939565 - (FL) DA PEDIATRIC REHABILITATIONFLHome Health Agency (251E00000X)
United
85244$18.371720747496 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH TRANSPLANT CENTER811723202 - PRISMA HEALTH - UPSTATESCGeneral Acute Care Hospital (282N00000X)
United
85244$8.571689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL752313255TXGeneral Acute Care Hospital (282N00000X)
United
85244$20.421740273994 - ECTOR COUNTY HOSPITAL DISTRICT, MEDICAL CENTER HOSPITAL752302928TXGeneral Acute Care Hospital (282N00000X)
United
85244$18.371114473212 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-FARIS811723202 - PRISMA HEALTH - UPSTATESCGeneral Acute Care Hospital (282N00000X)
United
85244$20.421134172406 - COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP, MEDICAL CITY ARLINGTON621682201 - COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LPTXGeneral Acute Care Hospital (282N00000X)
United
85244$44.921073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
85244$20.421447723945 - MEDICAL UNIVERSITY HOSPITAL AUTHORITY, MUSC HEALTH MARION MEDICAL CENTER571098556 - (SC) MEDICAL UNIVERSITY HOSPITAL AUTHORITYSCGeneral Acute Care Hospital (282N00000X)
United
85244$20.421821026816 - EAST COOPER COMMUNITY HOSPITAL, INC., EAST COOPER MEDICAL CENTER934555562SCGeneral 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 85244 vs. Other Hematology and Coagulation Procedures Codes

The CPT 85244 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 85244 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
85240-CPTLowClotting; Factor Viii (Ahg), One Stage
85244-CPTLowClotting;Factor Viii Relate Antigen Quan
85245-CPTLowClotting Factor Viii Vw Fact Ristoc
85246-CPTLowClotting Fact Viii Vw Fact Antigen

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85244. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 85244 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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