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See a sample rate comparisonCPT 85536 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.
Red Cell Iron Stain, This Test Adds Prussian Blue Dye To A Blood Sample. The Dye Binds To Iron That Is Not Absorbed By Red Blood Cells. This Condition Suggests Bone Marrow Disorders Or Anemias.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 59 - Distinct Procedural Service 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 85536 |
| Medicaid Fee Schedule | View Medicaid rates for 85536 |
National average reimbursement for CPT 85536 by major payers:
$6.14
$4.90
$7.37
$10.12
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CPT 85536
5 of 25 sample ratesHigher to lower in this preview
Da Pediatric Rehabilitation
$60.00Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$8.17Published rateAmisub Of South Carolina, Inc., Piedmont Medical Center
Amisub Of South Carolina Inc
$6.88Published rateGreenville Health System, Ghs Patewood Memorial Hospital
Prisma Health - Upstate
$6.19Published rateSunrise Home Health Care Inc.
Sunrise Home Health Care Inc
$3.61Published rate
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See a sample payer proposalCPT 85536 vs. Other Hematology and Coagulation Procedures Codes
The CPT 85536 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 85536 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.
| Code | Complexity | Description |
|---|---|---|
| 85441-CPT | Low | Heinz Body Blood Test, Heinz Bodies Are Injured Red Blood Cells That Stick To Cell Walls. The Test Is Done To Identify The Problem Which Can Be Caused By Drugs Enzyme Deficiencies Or Inherited Hemoglobin Disorders. |
| 85445-CPT | Low | Heinz Body Blood Test, Heinz Bodies Are Injured Red Blood Cells That Stick To Cell Walls. The Test Is Done To Identify The Problem Which Can Be Caused By Drugs Enzyme Deficiencies Or Inherited Hemoglobin Disorders. |
| 85536-CPT | Low | Red Cell Iron Stain, This Test Adds Prussian Blue Dye To A Blood Sample. The Dye Binds To Iron That Is Not Absorbed By Red Blood Cells. This Condition Suggests Bone Marrow Disorders Or Anemias. |
| 85540-CPT | Low | White Blood Cell Enzyme Test, The Leukocyte Alkaline Phosphatase Test (Lap) Measures The Amount Of Alkaline Phosphatase Enzyme Present In White Blood Cells. This Test Is Done To Aid In The Diagnosis Of Certain Blood Conditions. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85536. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85536 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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