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See a sample rate comparisonCPT 85730 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.
Blood Clotting Time, Partial Thromboplastin Time Assesses The Amount Of Time It Takes For Blood To Clot. The Test Screens For Bleeding Conditions And Is Used To Monitor The Dose Of Heparin And Other Blood Thinners.
| 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 | None 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 85730 |
| Medicaid Fee Schedule | View Medicaid rates for 85730 |
National average reimbursement for CPT 85730 by major payers:
$5.31
$4.29
$7.56
$8.82
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CPT 85730
5 of 25 sample ratesHigher to lower in this preview
Jimmy Morrison
Mainegeneral Health
$11.85Published rateGerald Mank
Blue Ridge Healthcare Medical Group Inc
$5.73Published rateKanak Das
$3.60Published rateHashim Khandwalla
Digestive And Liver Specialists Of Houston
$2.77Published rateJoycelyn Theard
Texas Institute Of Gastroenterology Assoc., P.A.
$2.51Published rate
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See a sample payer proposalCPT 85730 vs. Other Hematology and Coagulation Procedures Codes
The CPT 85730 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 85730 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 |
|---|---|---|
| 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. |
| 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. |
| 85730-CPT | Low | Blood Clotting Time, Partial Thromboplastin Time Assesses The Amount Of Time It Takes For Blood To Clot. The Test Screens For Bleeding Conditions And Is Used To Monitor The Dose Of Heparin And Other Blood Thinners. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 85730. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 85730 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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