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See a sample rate comparisonCPT 85613 Fee Schedule
Medicare rates as of January 2026
CPT 85613 is classified under Pathology and Laboratory Procedures, in the Hematology and Coagulation Procedures subgroup.
Russell Viper Venom Time Diluted
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 90 - Reference Laboratory 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | $9.58 national lab fee schedule rate (2026) · View Medicare rates for 85613 |
| Medicaid Fee Schedule | $8.815 median of the 8 states in the free preview · View Medicaid rates for 85613 |
National average reimbursement for CPT 85613 by major payers:
$8.50
BCBS / Anthem
$10.18
UnitedHealthcare
$11.36
Aetna
$13.96
Cigna
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CPT 85613
5 of 25 sample ratesHigher to lower in this preview
Kelley Parnell
Neuroscience Group Of Northeast Wisconsin, S.C.
$23.60Published rateSt. James Parish Hosp. Serv. Dist.
St James Parish Hospital
$13.14Published rateEctor County Hospital District, Medical Center Hospital
$9.57Published ratePrisma Health-Upstate, Prisma Health Int Med/Subspec Clinic
Prisma Health - Upstate
$8.61Published rateAlexander Tran Md PA
$4.01Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 85613 vs. Other Hematology and Coagulation Procedures Codes
The table lists codes related to 85613. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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. |
| 85611-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. |
| 85612-CPT | Low | Blood Clotting Test, This Test Checks For Deficiencies Of Several Critical Blood Clotting Proteins: Prothrombin Factor V Or Factor X. |
| 85613-CPT | Low | Russell Viper Venom Time Diluted |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85613. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85613 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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