BLOOD AND LAB TESTS

Complete blood count
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REFERENCE PRICE. This is what Medicare allows for this service. Say what coverage you have and this line will tell you whether that describes you.

$7.77

Medicare allowed amount · 2026 · CPT 85025

READ IN THE SOURCE

CPT 85025
·
LOINC 57021-8
— CBC W Auto Differential panel - Blood
Confirmed at NLM Clinical Table Search Service, LOINC table (https://clinicaltables.nlm.nih.gov/apidoc/loinc_items/v3/doc.html)

Open the source and check this number
The other published measure of this same service

$37.12 — average charge submitted for this service in CY2024, carried on this row as an alternate measure.

Where the CY2024 figures come from

CMS, Medicare Physician & Other Practitioners — by Geography and Service, calendar year 2024 (released 2026-05)

File
MUP_PHY_R26_P05_V10_D24_Geo.csv
Row
Rndrng_Prvdr_Geo_Lvl=National, HCPCS_Cd=85025, Place_Of_Srvc=O
Setting
O — provider office / non-facility setting
SHA-256
c26956788333d03c0080017121c19e8e4d9990e9fa8ff385d7e1a2849c45074a
Retrieved
2026-09-09

READ, not computed. CMS publishes one National row per HCPCS code per place of service in this file, and this figure is that row's field, rounded to the cent. Nothing is averaged, weighted or adjusted here. Open the file, filter to the row named above, and you will see the same number.

Agency
CMS
Geography
United States, one national rate (the lab fee schedule has no geographic adjustment)
Population
Medicare Part B beneficiaries; any laboratory billing Medicare
Source
CMS, Clinical Laboratory Fee Schedule, CY2026 Quarter 3 (PUF_CLFS_CY2026_Q3V1), effective 2026-01-01
LOINC
57021-8 — CBC W Auto Differential panel - Blood
Who this number does and does not describe

The standard blood count ordered at almost every workup visit. Medicare pays 100 percent of this rate and a Medicare patient owes nothing for it — clinical laboratory tests carry no deductible and no coinsurance under Part B. That $0 is MEDICARE-ONLY and is the single most misleading number in this dataset if it is copied into an out-of-pocket column. If you have private insurance you pay your deductible and then coinsurance on a negotiated rate that is normally higher than this one. If you are uninsured you are billed the charge shown beside this figure. There is one national rate with no geographic adjustment, because Congress set it from reported private-payer rates. The average CHARGE submitted for this test in 2024 was $37.12 — 4.8 times this rate.

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