How much does Medicare pay for CPT 85018?

Medicare allowed an average of $2.31 per service and paid $2.31 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $13.72, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 85018?

Blood count, hemoglobin. It was billed 285,425 times to 182,087 Medicare beneficiaries by 2,307 providers in 2024.

Does 85018 pay differently in an office than a hospital?

Yes. The allowed amount averaged $2.31 in an office setting and $2.29 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 85018 most?

Clinical Laboratory, with 173,816 services from 346 clinicians. Next are Nephrology, Family Practice, Pulmonary Disease.

CPT 85018

Blood count, hemoglobin

$2.31Medicare-allowed amount per service, averaged across 285,425 services

Providers submitted

$13.72

Asking price, not received

Medicare allowed

$2.31

The fee schedule figure

Medicare paid

$2.31

Balance is patient coinsurance

Providers submitted an average of $13.72 for this code and Medicare allowed $2.31 — 5.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $2.31 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $2.31
Hospital / facility: $2.29

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 285,120 services were billed in an office setting and 305 in a facility.

Services: 285,425
Beneficiaries: 182,087
Providers billing it: 2,307
Total allowed: $659,332

What Medicare pays for CPT 85018

Across 285,425 services billed by 2,307 providers to 182,087 beneficiaries, Medicare allowed an average of $2.31 per service. That is 1.6 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 85018

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	173,816	106,550	$2.32	346
Nephrology	20,513	8,988	$2.31	244
Family Practice	19,595	13,495	$2.31	498
Pulmonary Disease	13,661	12,425	$2.31	172
Internal Medicine	12,613	7,952	$2.31	225
Nurse Practitioner	11,250	8,298	$2.30	231
Pathology	6,574	4,431	$2.31	45
Obstetrics & Gynecology	5,488	5,272	$2.30	105
Urology	4,916	3,314	$2.30	72
Physician Assistant	4,651	4,028	$2.30	173
Hematology-Oncology	2,932	565	$2.31	20
Cardiology	2,306	1,914	$2.32	29
Endocrinology	934	732	$2.30	21
Critical Care (Intensivists)	813	787	$2.30	18
Gastroenterology	766	451	$2.26	6

85018 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	29,277	$2.31	$2.32	258
Florida	24,468	$2.33	$2.32	92
Texas	23,675	$2.31	$2.32	134
North Carolina	21,102	$2.31	$2.32	122
New Jersey	14,894	$2.32	$2.32	28
Minnesota	14,850	$2.31	$2.32	369
Tennessee	14,531	$2.31	$2.32	38
Georgia	14,231	$2.31	$2.32	113
Ohio	11,543	$2.31	$2.32	36
Arizona	9,498	$2.30	$2.32	55
Alabama	8,796	$2.31	$2.32	56
Massachusetts	8,546	$2.32	$2.32	46
Virginia	7,962	$2.31	$2.32	46
Illinois	7,582	$2.31	$2.32	71
New York	5,506	$2.31	$2.32	40
Wisconsin	5,147	$2.30	$2.32	81
Pennsylvania	4,820	$2.32	$2.32	16
Nevada	4,715	$2.30	$2.32	17
Kansas	4,472	$2.31	$2.32	22
Missouri	4,120	$2.30	$2.32	99
Mississippi	3,888	$2.30	$2.32	31
Iowa	3,828	$2.31	$2.32	63
Maryland	3,807	$2.31	$2.32	18
Washington	3,680	$2.31	$2.32	34
South Carolina	3,529	$2.31	$2.32	86
Nebraska	3,207	$2.31	$2.32	27
Oregon	2,671	$2.31	$2.32	44
Arkansas	2,644	$2.31	$2.32	42
Kentucky	2,088	$2.32	$2.32	24
Louisiana	1,995	$2.32	$2.32	15
Utah	1,579	$2.31	$2.32	20
Colorado	1,568	$2.32	$2.32	11
Hawaii	1,568	$2.30	$2.32	5
Oklahoma	1,433	$2.31	$2.32	8
Indiana	1,243	$2.26	$2.27	36
New Mexico	1,237	$2.32	$2.32	3
South Dakota	1,145	$2.32	$2.32	14
Michigan	1,076	$2.31	$2.32	22
Rhode Island	841	$2.32	$2.32	9
Connecticut	775	$2.32	$2.32	20
North Dakota	435	$2.31	$2.32	14
Delaware	403	$2.32	$2.32	2
New Hampshire	276	$2.32	$2.32	3
Puerto Rico	189	$2.32	$2.32	2
West Virginia	175	$2.32	$2.32	3
Maine	167	$2.32	$2.32	3
Montana	109	$2.30	$2.32	3
Wyoming	54	$2.32	$2.32	2
Vermont	41	$2.32	$2.32	2
Alaska	23	$2.22	$2.32	1
ZZ	16	$2.32	$2.32	1

Related codes

85025Complete blood cell count (red cells$7.59
85027Complete blood cell count (red cells$6.33
85045Red blood count$3.90
85014Red blood cell concentration measurement$2.31
85007Microscopic examination for white blood cells$3.71
85060Blood smear interpretation by physician$23.02
85097Bone marrow, smear interpretation$51.39
85046Red blood count automated$5.44
85044Red blood count$4.21
85055Reticulated (young) platelet measurement$34.89
85048Automated white blood cell count$2.47
85049Platelet count$4.37

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.