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See a sample rate comparisonCPT 85396 Fee Schedule
Medicare rates as of October 2026
CPT 85396 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
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
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $15.70 national non-facility rate (2026) · View Medicare rates for 85396 |
| Medicaid Fee Schedule | $15.41 median of the 8 states in the free preview · View Medicaid rates for 85396 |
National average reimbursement for CPT 85396 by major payers:
$22.54
BCBS / Anthem
$13.00
UnitedHealthcare
$22.01
Aetna
$20.26
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 85396.
CPT 85396
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$50.05Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$28.54Published rateChristopher Raio
St Joseph Hospital
$12.97Published rateMolly Mcintosh
Baycare Medical Group Inc
$8.85Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$7.55Published rate
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See a sample payer proposalCPT 85396 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85396. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 85379-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. |
| 85380-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. |
| 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. |
| 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 85396. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85396 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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