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See a sample rate comparisonCPT 85360 Fee Schedule
Medicare rates as of January 2026
CPT 85360 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
Blood Clot Absorption Test, This Test Measures The Amount Of Time A Clot Takes To Dissolve Fully Into The Blood. Results Indicate The Health Of This Function.
| 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 TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $8.41 national lab fee schedule rate (2026) · View Medicare rates for 85360 |
| Medicaid Fee Schedule | $8.305 median of the 8 states in the free preview · View Medicaid rates for 85360 |
National average reimbursement for CPT 85360 by major payers:
$7.72
BCBS / Anthem
$6.07
UnitedHealthcare
$9.95
Aetna
$12.56
Cigna
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CPT 85360
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$60.00Published rateChristopher Raio
Mercy Medical Center
$11.10Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$8.09Published rateOconee Medical Center
Prisma Health - Upstate
$7.57Published rateSacred Heart Health System Inc, Sacred Heart Home Care
Sacred Heart Health System Inc
$4.61Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 85360 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85360. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 85360-CPT | Low | Blood Clot Absorption Test, This Test Measures The Amount Of Time A Clot Takes To Dissolve Fully Into The Blood. Results Indicate The Health Of This Function. |
| 85362-CPT | Low | Blood Clotting Problem Test, This Test Is Done To Detect A Problem In The System That Regulates Blood Clotting. It Can Also Detect Whether A Hidden Blood Clot (One That Did Not Produce Symptoms) Has Occurred. |
| 85366-CPT | Low | Blood Clotting Problem Test, This Test Is Done To Detect A Problem In The System That Regulates Blood Clotting. It Can Also Detect Whether A Hidden Blood Clot (One That Did Not Produce Symptoms) Has Occurred. |
| 85370-CPT | Low | Blood Clotting Problem Test, This Test Is Done To Detect A Problem In The System That Regulates Blood Clotting. It Can Also Detect Whether A Hidden Blood Clot (One That Did Not Produce Symptoms) Has Occurred. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85360. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85360 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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