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See a sample rate comparisonCPT 85306 Fee Schedule
Medicare rates as of January 2026
CPT 85306 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
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.
| 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 | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $15.32 national lab fee schedule rate (2026) · View Medicare rates for 85306 |
| Medicaid Fee Schedule | $15.13 median of the 8 states in the free preview · View Medicaid rates for 85306 |
National average reimbursement for CPT 85306 by major payers:
$13.59
BCBS / Anthem
$15.97
UnitedHealthcare
$18.80
Aetna
$23.63
Cigna
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CPT 85306
5 of 25 sample ratesHigher to lower in this preview
Citizens Medical Center County Of Victoria, County Of Victoria Citizens Medical Center
$41.70Published rateSan Antonio Vamc
$21.40Published rateEmerus Bhs Sa Thousand Oaks LLC
$15.31Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Grove
Prisma Health - Upstate
$13.78Published rateSt. Davids Healthcare Partnership, L.P., LLP, Heart Hospital Of Austin
Lone Star Circle Of Care
$6.42Published rate
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See a sample payer proposalCPT 85306 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85306. 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. |
| 85306-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 85306. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85306 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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