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CPT 85460 Fee Schedule

Last Verified: September 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.

Fetal Cell Blood Count, This Test Checks For An Rh Incompatibility Between The Mother And Fetus And Evaluates The Possibility Of Excess Bleeding During Delivery. A Blood Sample From The Mother Is Checked For The Number Of Fetal Blood Cells.
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Hematology and Coagulation Procedures

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

26 - Professional component

TC - Technical component

Complexity LevelLow
Medicare Fee ScheduleView Medicare rates for 85460
Medicaid Fee ScheduleView Medicaid rates for 85460

National average reimbursement for CPT 85460 by major payers:

bcbs

$7.01

uhc

$5.42

aetna

$9.27

cigna

$11.51

Compare published rates across providers.

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CPT 85460
5 of 25 sample ratesHigher to lower in this preview
  1. Emerus Bhs Sa Thousand Oaks LLC

    TXGeneral Acute Care HospitalNPI 1275235426Tax ID 45-2497248

    $25.50Published rate
  2. Christopher Raio

    St Joseph Hospital

    NYEmergency Medicine PhysicianNPI 1255478004Tax ID 11-3438973

    $10.20Published rate
  3. Chca Mainland, L.P., Mainland Medical Center

    TXGeneral Acute Care HospitalNPI 1841237807Tax ID 62-1801360

    $7.73Published rate
  4. Christopher Raio

    Mercy Medical Center

    NYEmergency Medicine PhysicianNPI 1255478004Tax ID 11-1635088

    $4.64Published rate
  5. Ascension Seton, Ascension Seton Medical Center Austin

    Ascension Seton

    TXGeneral Acute Care HospitalNPI 1164526786Tax ID 74-1109643

    $2.94Published rate

National sample. Rates vary by location, specialty, and contract.

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CPT 85460 vs. Other Hematology and Coagulation Procedures Codes

The CPT 85460 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 85460 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
85460-CPTLowFetal Cell Blood Count, This Test Checks For An Rh Incompatibility Between The Mother And Fetus And Evaluates The Possibility Of Excess Bleeding During Delivery. A Blood Sample From The Mother Is Checked For The Number Of Fetal Blood Cells.
85461-CPTLowFetal Rosette (Rh) Blood Test, The Test Takes A Blood Sample From An Rh-Negative Mother After Delivery. When Stained Any Rh-Positive Red Cells In The Sample Will Form A Rosette. This Indicates If The Newborn Bled During The Birthing.
85651-CPTLowRed Blood Cell Test, This Test Measures The Rate At Which Red Blood Cells Sink To The Bottom Of A Test Tube. This Is A Nonspecific Test For Inflammation And Primarily Helps Detect Blood Cell And Vessel Conditions.
85652-CPTLowRed Blood Cell Test, This Test Measures The Rate At Which Red Blood Cells Sink To The Bottom Of A Test Tube. This Is A Nonspecific Test For Inflammation And Primarily Helps Detect Blood Cell And Vessel Conditions.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85460. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 85460 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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