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See a sample rate comparisonCPT 85400 Fee Schedule
Medicare rates as of January 2026
CPT 85400 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
Blood Clot Absorption Test, This Test Evaluates The Ability Of Plasmin To Break Up A Blood Clot So That It May Be Absorbed Into The Blood And Excreted. Plasmin Is A Limiting Factor That Stops The Clotting Process When A Wound Has Been Closed.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 11 - Office |
| Complexity Level | Low |
| Medicare Fee Schedule | $7.71 national lab fee schedule rate (2026) · View Medicare rates for 85400 |
| Medicaid Fee Schedule | $7.615 median of the 8 states in the free preview · View Medicaid rates for 85400 |
National average reimbursement for CPT 85400 by major payers:
$7.42
BCBS / Anthem
$5.99
UnitedHealthcare
$9.15
Aetna
$12.05
Cigna
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CPT 85400
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$16.96Published rateChristopher Raio
Mercy Medical Center
$9.16Published ratePrisma Health-Upstate, Prisma Health Center For Pediatric Med
Prisma Health - Upstate
$6.94Published rateMichael Shuler
Athens Orthopedic Clinic, P.A.
$4.63Published rateMatthew Lilley
The Orthopedic And Neurosurgical Center Of The Cascades
$3.24Published rate
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See a sample payer proposalCPT 85400 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85400. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 85400-CPT | Low | Blood Clot Absorption Test, This Test Evaluates The Ability Of Plasmin To Break Up A Blood Clot So That It May Be Absorbed Into The Blood And Excreted. Plasmin Is A Limiting Factor That Stops The Clotting Process When A Wound Has Been Closed. |
| 85410-CPT | Low | Blood Test Antiplasmin, This Test Measures Alpha-2 Antiplasmin Which Works In The Completion Of The Blood Clotting Process. |
| 85415-CPT | Low | Blood Clotting Test, This Test Looks For Plasminogen Which Is Present In The Blood Until Plasmin Is Needed To Turn Off The Clotting Process At A Wound. The Amount Is An Indicator Of The Bodys Ability To Perform Normal Healing Processes. |
| 85420-CPT | Low | Blood Clotting Test, This Test Looks For Plasminogen Which Is Present In The Blood Until Plasmin Is Needed To Turn Off The Clotting Process At A Wound. The Amount Is An Indicator Of The Bodys Ability To Perform Normal Healing Processes. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85400. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85400 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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