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CPT 85025

Blood Cell Count With Differential

Priced under CLFS

85025 · PFS Q3 2014 · Historical

Status X is not separately payable under the PFS.

View applicable payment rules
View CMS source and method

CPT 85025 has no published national rate. It carries status X (statutory exclusion) in the Q3 2014 release. The statutory definition of physician services does not include this item. The blank amount means unpriced, not $0.

PFS status evidence

Physician relative value file (Q3 2014) · rvu14c.zip (PPRRVU14_V0515.csv row 13,472)
Inspect PFS status evidence
Code
85025
Release
Q3 2014, revision 1
Result
Priced under CLFS

Citations

  • Shows this code’s PFS status (X). Result: Priced under CLFS.

    Physician relative value file (PPRRVU)

    Q3 2014 · revision 1

    Latest revision of this release

    Release period: July 1 – September 30, 2014

    This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

    Record details PPRRVU14_V0515.csv in rvu14c.zip (row 13,472)
    hcpcs (col 1)
    85025
    modifier (col 2)
    blank
    status_code (col 4)
    X

    SHA-256: c77da0d012ff73dec8680d5f6f50582fc7e72005bc55edb2f131a02f0b1c293c

    Original source file

Plain-text summary

Why is there no national PFS amount for 85025?

Its status indicator is X (statutory exclusion). The statutory definition of physician services does not include this item. Status X is not separately payable under the PFS.

About this code

Also known as Complete blood count (CBC)

A blood test counting red cells, white cells, and platelets, and sorting the white cells into their main types. It is one of the most widely used screening and monitoring tests. Medicare reported 26.2 million services under this code in CY2024.

Plain-language context only—not the official CPT descriptor and not coding guidance

Payment considerations Copy link

Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.

Other fee-schedule routing Applies
Other payment indicators (9)

Facility/non-facility: Not determined, Professional/technical component: Does not apply, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, NCCI same-day edits: Not determined, MUE behavior: Not determined, Contractor pricing: Does not apply.

Why would a Medicare claim for 85025 be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

  • Its status indicator is X (statutory exclusion)—The statutory definition of physician services does not include this item. See status indicators

Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.

Payment review for 85025 Copy link

A blood count, a related blood-count method, and the specimen collection are separate services. Check the lab fee source, repeat-test rules, and any reflex testing before deciding two amounts are inconsistent.

What to check

  • Compare 85025 with nearby lab codes by the method actually performed, not by the shared “CBC” shorthand.
  • Use the current CLFS amount, and don’t read an unpriced PFS line as a zero-dollar allowance.
  • Treat a repeat or manual follow-up as separately payable only when the service performed and the applicable edits support it.

Codes to compare

National Q3 2014 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.

Code Office Facility
85027 Related blood count — —
85004 Related differential test — —
36415 Separate specimen collection — —
Check an actual payment Model this code in a contract

Sources: CMS Clinical Laboratory Fee Schedule; CMS Medicare NCCI Policy Manual (2026); CMS Medicare Claims Processing Manual (Pub. 100-04).

Which billing rules and modifiers apply? Copy link

Global period: what 85025's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

Can you bill it with another code? Copy link

Check a pair of codes Copy link

Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit for the pair.

See every current NCCI pair for 85025 →

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for 85025 across quarterly releases.

Release Status Office Facility
Q4 2026 takes effect Oct 1, 2026 X — —
Q3 2026 Jul 1, 2026 – Sep 30, 2026 X — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 X — —
When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Usage and related codes Copy link

How often 85025 is billed Copy link

Across Original Medicare in CY2024, 85025 ranked #7 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars. It repeats: a patient billed for it in 2024 was billed 2.2 times on average that year.

Beneficiaries
11.9M
Office + facility beneficiaries combined
Services
26.2M
Times it was billed
Allowed
$199.0M
Total Medicare allowed dollars
Compare: ↑ #6 more popular · 99232 ↓ #8 less popular · 99215

2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q3 2014 fee schedule above.

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q3 2014 release (effective July 2014). National baselines use GPCI 1.000 and exclude sequestration. Whether a national amount exists depends on the status and CMS’s payment instructions; blank RVUs are never treated as zero. Past releases are never edited, so these sources stay valid after CMS publishes a newer one. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.

Physician relative value file (Q3 2014) · rvu14c.zip (PPRRVU14_V0515.csv row 13,472)

Use the (i) buttons next to each amount above for the exact row, columns, and math.

Cite this rate

The citation names the release, so anyone can check it even after CMS publishes a newer one.

CPT 85025 National PFS baseline: No national PFS rate (Q3 2014; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/85025/2014/C