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See a sample rate comparisonCPT 85246 Fee Schedule
Medicare rates as of January 2026
CPT 85246 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
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.
| 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 85246 |
| Medicaid Fee Schedule | $21.105 median of the 8 states in the free preview · View Medicaid rates for 85246 |
National average reimbursement for CPT 85246 by major payers:
$20.36
BCBS / Anthem
$15.86
UnitedHealthcare
$26.92
Aetna
$34.05
Cigna
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CPT 85246
5 of 25 sample ratesHigher to lower in this preview
Da Pediatric Rehabilitation
$60.00Published rateWaccamaw Community Hospital, Tidelands Waccamaw Community Hospital
Waccamaw Community Hospital
$22.94Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Faris
Prisma Health - Upstate
$20.64Published rateSunrise Home Health Care Inc.
Sunrise Home Health Care Inc
$12.81Published rateCharleston Radiologists PA
Charleston Radiologists, P.A.
$6.12Published rate
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See a sample payer proposalCPT 85246 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85246. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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. |
| 85247-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 85246. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85246 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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