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See a sample rate comparisonCPT 85385 Fee Schedule
Last Verified: September 2026
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.
Blood Clotting Test, The Fibrinogen Test Is One Of 13 Clotting Factors That Can Be Measured When A Problem Is Suspected. The Test May Follow Up Another Type Of Clotting Test Or It May Be Ordered As Part Of An Evaluation Of The Heart.
| 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 | None 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 85385 |
| Medicaid Fee Schedule | View Medicaid rates for 85385 |
National average reimbursement for CPT 85385 by major payers:
$11.36
$8.05
$13.66
$20.81
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CPT 85385
5 of 25 sample ratesHigher to lower in this preview
Christopher Raio
St Joseph Hospital
$19.09Published rateBaptist Hospitals Of Southeast Texas, Memorial Hermann Baptist Beaumont Hospital
Baptist Hospitals Of Southeast Texas
$14.46Published rateKelly Ridges
Allergy & Asthma Of Dupage, S.C.
$11.57Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$8.59Published rateBaptist Health Care, Inc., Baptist Home Healt Care And Medical Equipment
Baptist Health Care Inc
$4.98Published rate
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See a sample payer proposalCPT 85385 vs. Other Hematology and Coagulation Procedures Codes
The CPT 85385 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 85385 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.
| Code | Complexity | Description |
|---|---|---|
| 85384-CPT | Low | Blood Clotting Protein Test, The Factor I Test Measures The Activity Level Of Fibrinogen One Of 20 Proteins Needed For Blood Clotting. It Is Made In The Liver. When An Injury Occurs Fibrinogen Binds To Other Proteins At A Wound Site To Form A Barrier To Prevent Additional Blood Loss. |
| 85385-CPT | Low | Blood Clotting Test, The Fibrinogen Test Is One Of 13 Clotting Factors That Can Be Measured When A Problem Is Suspected. The Test May Follow Up Another Type Of Clotting Test Or It May Be Ordered As Part Of An Evaluation Of The Heart. |
| 85390-CPT | Low | Dic Screen For Blood Clotting, The Disseminated Intravascular Coagulation (Dic) Screen Consists Of Three Tests: Platelet Count D-Dimer And Fibrinogen Levels And Blood Clotting Time. Dic Occurs In Response To Infection Or Injury Forming Blood Clots Throughout The Body. |
| 85396-CPT | Low | Clotting Assay Whole Blood, Coagulation Fibrinolysis Assay Whole Blood Eg Viscoelastic Clot Assessment Including Use Of Any Pharmacologic Additive S As Indicated Including Interpretation And Written Report Per Day |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85385. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85385 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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