CPT 85660 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Hematology and Coagulation Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 85660 |
| Medicaid Fee Schedule | View Medicaid rates for 85660 |
National average reimbursement for CPT 85660 by major payers:
$4.91
$3.92
$6.46
$8.06
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 85660 | $5.51 | 1093793408 - JACKSON PARISH HOSPITAL, JACKSON PARISH HOSPITAL | 720549907 | LA | Critical Access Hospital (282NC0060X) |
United | 85660 | $5.51 | 1144274127 - PROGRESSIVE ACUTE CARE DAUTERIVE, LLC, DAUTERIVE HOSPITAL | 364756243 - (LA) PROGRESSIVE ACUTE CARE DAUTERIVE LLC | LA | General Acute Care Hospital (282N00000X) |
United | 85660 | $3.15 | 1851390967 - UHS OF TEXOMA, INC, TEXOMA MEDICAL CENTER | 205908627 - UHS OF TEXOMA INC | TX | General Acute Care Hospital (282N00000X) |
United | 85660 | $40.00 | 1649599168 - RESTORATIVE HEALTH REHABILITATION INC | 272533824 - (FL) RESTORATIVE HEALTH REHABILITATION INC | FL | Home Health Agency (251E00000X) |
United | 85660 | $6.61 | 1689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL | 752313255 | TX | General Acute Care Hospital (282N00000X) |
United | 85660 | $5.51 | 1114976263 - SLIDELL MEMORIAL HOSPITAL, MD IMAGING SLIDELL | 726014895 - (LA) SLIDELL MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 85660 | $5.51 | 1821098286 - TOURO INFIRMARY | 720423659 - (LA) TOURO INFIRMARY | LA | General Acute Care Hospital (282N00000X) |
United | 85660 | $3.16 | 1669480323 - KELL WEST REGIONAL HOSPITAL LLC | 752756307 - KELL WEST REGIONAL HOSPITAL, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 85660 | $5.51 | 1477516466 - SCOTT & WHITE MEMORIAL HOSPITAL, BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE | 741166904 - SCOTT & WHITE MEMORIAL HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 85660 | $6.55 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 85660 | $7.11 | 1588648315 - POINTE COUPEE PARISH HEALTH SERVICES DISTRICT NUMBER ONE, POINTE COUPEE GENERAL HOSPITAL | 721054801 | LA | Critical Access Hospital (282NC0060X) |
United | 85660 | $4.41 | 1851768337 - KELLY RIDGES | 362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C. | IL | Family Nurse Practitioner (363LF0000X) |
United | 85660 | $4.41 | 1255766531 - MARISSA LIVERIS | 362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C. | IL | Physician Assistant (363A00000X) |
United | 85660 | $5.51 | 1669752234 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 85660 | $3.31 | 1861650780 - CHILDRENS NATIONAL MEDICAL CENTER | 530196580 - CHILDRENS HOSPITAL | DC | Children's Hospital (282NC2000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 85660 vs. Other Hematology and Coagulation Procedures Codes
The CPT 85660 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 85660 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 |
|---|---|---|
| 85460-CPT | Low | 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. |
| 85461-CPT | Low | Fetal 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-CPT | Low | Red 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. |
| 85660-CPT | Low | Test For Sickle Cells, The Test Detects Red Blood Cells With Too Much Hemoglobin S Which Causes Red Blood Cells To Deform To An Oval Shape And Disrupt Blood Flow To Major Organs. This In Turn Can Result In Sickle Cell Anemia. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85660. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85660 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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