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CPT 85445 Fee Schedule

Last Verified: January 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.

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
Medicare Fee ScheduleView Medicare rates for 85445

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$2.861366442600 - MICHAEL JACOBSON541958039 - HROA 401K PLANVAOtolaryngology Physician (207Y00000X)
United
85445$9.351588654966 - ST. JAMES PARISH HOSP. SERV. DIST.726010747 - (LA) ST JAMES PARISH HOSPITALLACritical Access Hospital (282NC0060X)
United
85445$3.911093783391 - CHRISTUS SPOHN HEALTH SYSTEM CORPORATION, CHRISTUS SPOHN HOSPITAL KLEBERG760422435 - C H WILKINSON PHYSICIAN NETWORKTXGeneral Acute Care Hospital (282N00000X)
United
85445$4.091861650780 - CHILDRENS NATIONAL MEDICAL CENTER530196580 - CHILDRENS HOSPITALDCChildren's Hospital (282NC2000X)
United
85445$8.681407947336 - CLHG-VILLE PLATTE LLC, MERCY REGIONAL MEDICAL CENTER824681222LAGeneral Acute Care Hospital (282N00000X)
United
85445$6.131104057694 - SPECIALISTS HOSPITAL SHREVEPORT, LLC208810573 - (LA) SPECIALISTS HOSPITAL SHREVEPORT, L.L.C.LAGeneral Acute Care Hospital (282N00000X)
United
85445$3.681255478004 - CHRISTOPHER RAIO113438973 - ST JOSEPH HOSPITALNYEmergency Medicine Physician (207P00000X)
United
85445$6.821275580938 - CHCA WEST HOUSTON L P, HCA HOUSTON HEALTHCARE WEST621801363 - (TX) CHCA WEST HOUSTON L PTXGeneral Acute Care Hospital (282N00000X)
United
85445$15.001073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
85445$3.681255478004 - CHRISTOPHER RAIO111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
85445$6.821427472463 - RESOLUTE HOSPITAL COMPANY, LLC, RESOLUTE HEALTH HOSPITAL462942963 - (TX) RESOLUTE HOSPITAL COMPANY LLCTXGeneral Acute Care Hospital (282N00000X)
United
85445$6.821528027786 - METHODIST HOSPITALS OF DALLAS, METHODIST DALLAS MEDICAL CENTER750800661 - METHODIST HOSPITALS OF DALLASTXGeneral Acute Care Hospital (282N00000X)
United
85445$6.821154618742 - VHS HARLINGEN HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER452662980TXGeneral Acute Care Hospital (282N00000X)
United
85445$3.681255478004 - CHRISTOPHER RAIO111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
85445$9.521225087794 - AMARILLO VAMC751616212TXGeneral 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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