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See a sample rate comparisonCPT 85415 Fee Schedule
Medicare rates as of January 2026
CPT 85415 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
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.
| 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 | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $17.19 national lab fee schedule rate (2026) · View Medicare rates for 85415 |
| Medicaid Fee Schedule | $15.815 median of the 8 states in the free preview · View Medicaid rates for 85415 |
National average reimbursement for CPT 85415 by major payers:
$15.30
BCBS / Anthem
$11.46
UnitedHealthcare
$19.79
Aetna
$25.53
Cigna
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CPT 85415
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$37.82Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$20.42Published rateFoundation Bariatric Hospital Of San Antonio, LLC, Foundation Surgical Hospital Of San Antonio
Foundation Bariatric Hospital Of San Antonio, LLC
$17.19Published rateNevada Eye Care Professionals Little & Stein, Ltd.
Nevada Eye Care Professionals
$10.09Published rateAsya Segalene
Allergy & Asthma Of Dupage, S.C.
$6.30Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 85415 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85415. 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 85415. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85415 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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