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CPT 85379 Fee Schedule

Last Verified: December 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Fibrin Degradat Prod D-Dimer Quan
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Hematology and Coagulation Procedures

Common Place of Service

23 - Emergency Room

81 - Independent Laboratory

Common Modifiers

None

26 - Professional component

TC - Technical component

Complexity LevelLow

National average reimbursement for CPT 85379 by major payers:

bcbs

$8.77

uhc

$7.85

aetna

$12.93

cigna

$15.18

Preview provider-level rates for...
For billing codeCPT 85379
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 85379

United
85379$5.281184289613 - MERIDIAN PRIMARY CARE PLLC825070439 - (TX) MERIDIAN PRIMARY CARE PLLCTXFamily Medicine Physician (207Q00000X)
United
85379$6.051932593530 - GENERATIONS VISITING PRACTITIONERS LLC473308393 - (TX) GENERATIONS VISITING PRACTITIONERS LLCTXFamily Medicine Physician (207Q00000X)
United
85379$4.281972544500 - DAVID SPINKS822255794 - (TX) CROSSPOINTE MEDICAL CLINICTXFamily Medicine Physician (207Q00000X)
United
85379$5.821255394920 - DEREK SKINNER813787765 - (TX) PARATUS MEDICAL DBA HIGH PLAINS PRIMARY CARETXFamily Medicine Physician (207Q00000X)
United
85379$6.051700852183 - JAMES EARHART742867580 - HEART OF TEXAS COMMUNITY HEALTH CENTER INCTXFamily Medicine Physician (207Q00000X)
United
85379$6.051295737245 - CHRISTOPHER PUTNEY742690907 - (TX) FAMILY MEDICINE ASSOCS OF ROUND ROCK, P.A.TXFamily Medicine Physician (207Q00000X)
United
85379$5.821629056304 - SHANNON SCHRADER760226835 - (TX) TRIANGLE AREA NETWORK INCTXFamily Medicine Physician (207Q00000X)
United
85379$5.501548247356 - STEVEN POWELL742109824 - (TX) AUSTIN REGIONAL CLINIC PATXFamily Medicine Physician (207Q00000X)
United
85379$5.961184665952 - CHARLES PAJESTKA752175676 - (TX) CHARLES R PAJESTKA MDTXFamily Medicine Physician (207Q00000X)
United
85379$5.501689004558 - NATALIE WILLIAMS742109824 - (TX) AUSTIN REGIONAL CLINIC PATXFamily Medicine Physician (207Q00000X)
United
85379$4.281356374854 - FIRST PHYSICIANS, PLLC752713933 - (TX) MICHAEL V. SHELTON, M.D., P.A.TXFamily Medicine Physician (207Q00000X)
United
85379$6.111023002292 - ALBERTO ROMERO760677370 - (TX) BAYCENTER FAMILY PHYSICIAN PATXFamily Medicine Physician (207Q00000X)
United
85379$4.281184771958 - PAUL SAENZ900120192 - (TX) SPORTS MEDICINE ASSOCIATES OF SAN ANTONIOTXFamily Medicine Physician (207Q00000X)
United
85379$19.601679910590 - SHEIKH KARIM-UD-DIN742958277 - SCOTT & WHITE CLINICTXFamily Medicine Physician (207Q00000X)
United
85379$10.591265736367 - MUHAMMAD SIDDIQUE752536818 - HEALTHTEXAS PROVIDER NETWORKTXFamily Medicine Physician (207Q00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 85379 vs. Other Hematology and Coagulation Procedures Codes

The CPT 85379 code is part of the Pathology and Laboratory Procedures services used for Hematology and Coagulation Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 85379 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
85378-CPTLowFibrin Degradat Prod D-Dimer Semiql
85379-CPTLowFibrin Degradat Prod D-Dimer Quan
85380-CPTLowFibrin Degradation Products, D-Dimer; Ultrasensitive (Eg, For Evaluation For Venous Thromboembolism), Qualitative Or Semiquantitative
85384-CPTLowFibrinogen Activity

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85379. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 85379 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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