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See a sample rate comparisonCPT 85303 Fee Schedule
Medicare rates as of January 2026
CPT 85303 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
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.
| 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 | $13.84 national lab fee schedule rate (2026) · View Medicare rates for 85303 |
| Medicaid Fee Schedule | $13.665 median of the 8 states in the free preview · View Medicaid rates for 85303 |
National average reimbursement for CPT 85303 by major payers:
$12.40
BCBS / Anthem
$10.81
UnitedHealthcare
$17.36
Aetna
$21.17
Cigna
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CPT 85303
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$30.45Published rateWilbarger County Hospital District, Wilbarger General Hospital
Wilbarger General Hospital Employee Benefit Plan
$16.61Published rateBay Area Healthcare Group, Ltd., Corpus Christi Medical Center
$13.84Published ratePrisma Health-Upstate
Prisma Health - Upstate
$12.46Published rateNorthwest Texas Surgical Hospital, LLC, Northwest Texas Surgery Center
Northwest Texas Surgical Hospital LLC
$5.80Published rate
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See a sample payer proposalCPT 85303 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85303. 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 85303. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85303 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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