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See a sample rate comparisonCPT 85245 Fee Schedule
Medicare rates as of January 2026
CPT 85245 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
Blood Protein Binding Test, In This Test An Antibiotic Is Added To A Sample Of Blood Plasma To See If A Clot Begins To Form. The Test Can Identify Problems With Blood Clotting.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $22.94 national lab fee schedule rate (2026) · View Medicare rates for 85245 |
| Medicaid Fee Schedule | $21.105 median of the 8 states in the free preview · View Medicaid rates for 85245 |
National average reimbursement for CPT 85245 by major payers:
$20.35
BCBS / Anthem
$15.80
UnitedHealthcare
$26.36
Aetna
$33.71
Cigna
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CPT 85245
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$50.47Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$23.20Published rateEast Cooper Community Hospital, Inc., East Cooper Medical Center
$22.94Published ratePrisma Health-Upstate, Prisma Health Center For Pediatric Med
Prisma Health - Upstate
$20.64Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$11.98Published rate
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See a sample payer proposalCPT 85245 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85245. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 85240-CPT | Low | Clotting; Factor Viii (Ahg), One Stage |
| 85244-CPT | Low | Blood Clotting Test, The Test Measures The Quantity Of Blood Clotting Protein Factor Viii One Of 13 Proteins Required For Normal Blood Clotting. |
| 85245-CPT | Low | Blood Protein Binding Test, In This Test An Antibiotic Is Added To A Sample Of Blood Plasma To See If A Clot Begins To Form. The Test Can Identify Problems With Blood Clotting. |
| 85246-CPT | Low | Blood Clotting Protein Test, In This Test A Sample Of Blood Plasma Is Examined For The Presence And Amount Of Von Willebrand Factor (Vwf) A Protein Essential For Delivering Protein Factor Viii To Wound Sites. Low Levels Of Vwf Weaken Blood Clotting Ability. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85245. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85245 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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