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See a sample rate comparisonCPT 85300 Fee Schedule
Medicare rates as of January 2026
CPT 85300 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 81 - Independent Laboratory 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $11.85 national lab fee schedule rate (2026) · View Medicare rates for 85300 |
| Medicaid Fee Schedule | $11.70 median of the 8 states in the free preview · View Medicaid rates for 85300 |
National average reimbursement for CPT 85300 by major payers:
$10.51
BCBS / Anthem
$8.22
UnitedHealthcare
$14.39
Aetna
$18.09
Cigna
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CPT 85300
5 of 25 sample ratesHigher to lower in this preview
Chi St. Luke'S Health Baylor College Of Medicine Medical Center
Chi St Lukes Health Baylor College Of Medicine Medical Center
$21.95Published rateNorth Houston, Hca Houston Healthcare Tomball
$11.85Published rateVhs Harlingen Hospital Company, LLC, Valley Baptist Micro-Hospital Weslaco
$11.85Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Greer
Prisma Health - Upstate
$10.67Published rateHospital Service District Of The Parish Of St. Bernard, State Of Louis, St. Bernard Parish Hospital
Hospital Service District Of The Parish Of St Bernard State Of Louis
$4.98Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 85300 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85300. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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. |
| 85301-CPT | Low | Blood Clotting Test, Antithrombin Is A Protein That Prevents And Regulates Blood Clotting. This Test Measures The Amount Of Antithrombin Iii To Pinpoint The Cause Of Excessive Clotting. |
| 85302-CPT | Low | Blood Test Protein C, Measures The Level Of Protein C A Blood Protein Important In The Regulation Of Clotting. The Test Is Done If A Person Or Family Members Have A History Of Blood Clots. |
| 85303-CPT | Low | Blood Test Protein C, Measures The Level Of Protein C A Blood Protein Important In The Regulation Of Clotting. 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 85300. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85300 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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