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See a sample rate comparisonCPT 85525 Fee Schedule
Medicare rates as of January 2026
CPT 85525 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
Removal Of Heparin From Sample, Heparin Is An Anti-Clotting Drug Frequently Given After Surgery. Prior To Testing Blood Heparin Is Removed From The Sample So That Evaluation Of Liver Function Is Accurate.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 21 - Inpatient Hospital 81 - Independent Laboratory |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $11.84 national lab fee schedule rate (2026) · View Medicare rates for 85525 |
| Medicaid Fee Schedule | $11.69 median of the 8 states in the free preview · View Medicaid rates for 85525 |
National average reimbursement for CPT 85525 by major payers:
$10.49
BCBS / Anthem
$10.89
UnitedHealthcare
$13.00
Aetna
$17.87
Cigna
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CPT 85525
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$40.00Published rateWilbarger County Hospital District, Wilbarger General Hospital
Wilbarger General Hospital Employee Benefit Plan
$14.21Published rateEast Cooper Community Hospital, Inc., East Cooper Medical Center
$11.84Published rateAnn Steck
Toledo Hospital
$7.22Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$6.39Published rate
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See a sample payer proposalCPT 85525 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85525. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 85520-CPT | Low | Heparin Blood Test, This Test Helps To Manage Low-Dose Heparin Therapy. It Is A Simple Measure Of The Amount Of Heparin Present In A Blood Sample. |
| 85525-CPT | Low | Removal Of Heparin From Sample, Heparin Is An Anti-Clotting Drug Frequently Given After Surgery. Prior To Testing Blood Heparin Is Removed From The Sample So That Evaluation Of Liver Function Is Accurate. |
| 85530-CPT | Low | Heparin Antidote Tolerance, Protamine Is Given As An Antidote For Too Much Heparin A Blood Thinner Often Given After Surgery. Hypersensitivity Is Common So This Test Is Done To Determine Whether Protamine Can Be Given And How Much Can Be Tolerated. |
| 85576-CPT | Low | Platelet (Clotting) Test, Platelets Are Red Blood Cells That Clump Together When Blood Clots. This Test Adds A Material To Stimulate Clumping To A Blood Sample And Then Measures How Long Before Clumping Starts And How Well The Cells Stick Together. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85525. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85525 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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