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CPT 85445 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.

Heinz Bodies;Induc,Acetyl Phenylhyd
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Hematology and Coagulation Procedures

Common Place of Service

81 - Independent Laboratory

11 - Office

Common Modifiers

None

90 - Reference Laboratory

Complexity LevelLow

National average reimbursement for CPT 85445 by major payers:

bcbs

$6.31

uhc

$4.81

aetna

$7.38

cigna

$10.31

Preview provider-level rates for...
For billing codeCPT 85445
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 85445

United
85445$3.931609823194 - SACRED HEART HEALTH SYSTEM INC, SACRED HEART HOME CARE590634434 - SACRED HEART HEALTH SYSTEM INCFLHome Health Agency (251E00000X)
United
85445$6.901013915149 - BAYCARE HOME CARE, INC., DBA SARASOTA MEMORIAL HOME CARE593582520 - (FL) BAYCARE HOME CARE INCFLHome Health Agency (251E00000X)
United
85445$35.001588756076 - ALL WAYS HOMECARE INC202696236FLHome Health Agency (251E00000X)
United
85445$4.091255478004 - CHRISTOPHER RAIO208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PCNYEmergency Medicine Physician (207P00000X)
United
85445$9.341255478004 - CHRISTOPHER RAIO111635088 - MERCY MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
85445$15.001073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
85445$6.821629021845 - ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP, NORTH AUSTIN MEDICAL CENTER742781812TXGeneral Acute Care Hospital (282N00000X)
United
85445$9.001255478004 - CHRISTOPHER RAIO208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PCNYEmergency Medicine Physician (207P00000X)
United
85445$12.991255478004 - CHRISTOPHER RAIO111635088 - MERCY MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
85445$4.091255478004 - CHRISTOPHER RAIO112050523 - ST FRANCIS HOSPITALNYEmergency Medicine Physician (207P00000X)
United
85445$3.681255478004 - CHRISTOPHER RAIO112050523 - ST FRANCIS HOSPITALNYEmergency Medicine Physician (207P00000X)
United
85445$15.001073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
85445$5.461851768337 - KELLY RIDGES362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C.ILFamily Nurse Practitioner (363LF0000X)
United
85445$2.861366442600 - MICHAEL JACOBSON541958039 - HROA 401K PLANVAOtolaryngology Physician (207Y00000X)
United
85445$4.091295736734 - CHRISTUS HEALTH ARK-LA-TEX, CHRISTUS ST. MICHAEL HEALTH SYSTEM752616977 - CHRISTUS TRINITY CLINICTXGeneral Acute Care Hospital (282N00000X)
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 85445 vs. Other Hematology and Coagulation Procedures Codes

The CPT 85445 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 85445 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
85441-CPTLowHeinz Bodies; Direct
85445-CPTLowHeinz Bodies;Induc,Acetyl Phenylhyd
85536-CPTLowIron Stain, Peripheral Blood
85540-CPTLowLeukocyte Alkaline Phosphatase With Coun

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85445. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 85445 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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