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See a sample rate comparisonCPT 85292 Fee Schedule
Medicare rates as of January 2026
CPT 85292 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
Clot;Prekallikrein Assay (Fletcher)
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 81 - Independent Laboratory |
| Common Modifiers | 90 - Reference Laboratory Q4 - Service for ordering / referring physician qualifies as a service exemption for laboratory services |
| Complexity Level | Low |
| Medicare Fee Schedule | $18.93 national lab fee schedule rate (2026) · View Medicare rates for 85292 |
| Medicaid Fee Schedule | $17.415 median of the 8 states in the free preview · View Medicaid rates for 85292 |
National average reimbursement for CPT 85292 by major payers:
$17.41
BCBS / Anthem
$13.06
UnitedHealthcare
$21.99
Aetna
$28.81
Cigna
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CPT 85292
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$41.65Published rateChristopher Raio
St Joseph Hospital
$25.94Published ratePrisma Health-Upstate
Prisma Health - Upstate
$17.04Published rateChristopher Raio
St Francis Hospital
$11.36Published rateMolly Mcintosh
Baycare Medical Group Inc
$3.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 85292 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85292. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 85292-CPT | Low | Clot;Prekallikrein Assay (Fletcher) |
| 85293-CPT | Low | Clotting; High Molecular Wght Kininogen Assay (Fitzgerald Fctor, Clotting; High Molecular Weight Kininogen Assay (Fitzgerald Factor Ass |
| 85300-CPT | Low | Blood Clotting Test, Antithrombin Is A Protein That Prevents And Regulates Blood Clotting. The Test Is Done If A Person Or Family Members Have A History Of Blood Clots. |
| 85305-CPT | Low | Blood Clotting Protein Test, Protein S Plays A Role In Regulating The Blood Clotting Process. The Test Is Done If A Person Or Family Members Have A History Of Blood Clots. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85292. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85292 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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