CPT 85025: complete blood count (CBC) with differential. What Medicare pays and what to ask
The CBC is among the most billed blood tests. Here is what 85025 covers and what Medicare's laboratory rate is.
What this code means
CPT 85025 is a complete blood count done by an automated analyzer, including a differential count of the white blood cell types.
It looks at red cells, white cells and platelets and is often ordered in emergency rooms and routine check-ups.
Why the bill can be much higher than the Medicare rate
The blood draw is billed separately, normally with 36415.
Lab prices on hospital bills often follow the hospital's own price list, which can be many times the Medicare laboratory rate.
| If a line is billed at | It would be |
|---|---|
| 5x the Medicare rate | $38.85 |
| 10x the Medicare rate | $77.70 |
| 20x the Medicare rate | $155.40 |
The Medicare rate is a published benchmark, not a legal ceiling on what a provider may charge. Our free scan flags a line as worth a closer look when it is billed at more than 10 times the Medicare rate.
Questions worth asking before you pay
- Was a CBC done once or twice on this date, and why?
- Is the code 85025 (with differential) or a CBC without differential?
- Is the blood draw (36415) listed once?
Check every line against the official Medicare rates in about a minute. The scan is free.
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Source: Medicare Clinical Laboratory Fee Schedule (CMS, 2026), national payment limit. Last updated October 2026. This page is general information, not legal or medical advice. Rates change each year and a hospital bill can include charges that the benchmark does not cover.