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See a sample rate comparisonCPT 85598 Fee Schedule
Medicare rates as of January 2026
CPT 85598 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
Lupus Anticoagulant Test, Three Tests Are Used To Identify A Specific Type Of Clotting Problem Caused By Lupus Anticoagulant. Typically The Tests Are Done As A Series More Than Once To Ensure The Outcome Is Accurate.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 81 - Independent Laboratory 21 - Inpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $17.98 national lab fee schedule rate (2026) · View Medicare rates for 85598 |
| Medicaid Fee Schedule | $17.755 median of the 8 states in the free preview · View Medicaid rates for 85598 |
National average reimbursement for CPT 85598 by major payers:
$15.53
BCBS / Anthem
$11.93
UnitedHealthcare
$19.62
Aetna
$54.53
Cigna
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CPT 85598
5 of 25 sample ratesHigher to lower in this preview
Alan Meltzer
Atlantic Health System Inc
$25.92Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$21.36Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$18.19Published rateNevada Eye Care Professionals Little & Stein, Ltd.
Nevada Eye Care Professionals
$10.63Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$6.28Published rate
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See a sample payer proposalCPT 85598 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85598. 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. |
| 85598-CPT | Low | Lupus Anticoagulant Test, Three Tests Are Used To Identify A Specific Type Of Clotting Problem Caused By Lupus Anticoagulant. Typically The Tests Are Done As A Series More Than Once To Ensure The Outcome Is Accurate. |
| 85610-CPT | Low | Test Prothrombin Clotting Time, The Prothrombin Time Test Measures How Well Blood Clots. The Test Commonly Assesses The Effectiveness Of Drugs For Thinning Blood Or Preventing Clots. The Test Also Detects Deficiencies In The Proteins Necessary For Clotting. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85598. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85598 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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