How much does Medicare pay for CPT 85044?

Medicare allowed an average of $4.21 per service and paid $4.21 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $19.22, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 85044?

Red blood count, manual test. It was billed 42,538 times to 29,121 Medicare beneficiaries by 216 providers in 2024.

Which specialty bills 85044 most?

Clinical Laboratory, with 17,304 services from 43 clinicians. Next are Hematology-Oncology, Medical Oncology, Internal Medicine.

CPT 85044

Red blood count, manual test

$4.21Medicare-allowed amount per service, averaged across 42,538 services

Providers submitted

$19.22

Asking price, not received

Medicare allowed

$4.21

The fee schedule figure

Medicare paid

$4.21

Balance is patient coinsurance

Providers submitted an average of $19.22 for this code and Medicare allowed $4.21 — 4.6× 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 $4.21 (100%); the rest is the patient’s coinsurance and deductible.

Services: 42,538
Beneficiaries: 29,121
Providers billing it: 216
Total allowed: $179,085

What Medicare pays for CPT 85044

Across 42,538 services billed by 216 providers to 29,121 beneficiaries, Medicare allowed an average of $4.21 per service. That is 1.5 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 85044

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	17,304	11,896	$4.22	43
Hematology-Oncology	16,638	10,995	$4.20	87
Medical Oncology	4,124	2,709	$4.21	18
Internal Medicine	1,721	1,357	$4.21	30
Hospitalist	713	498	$4.22	2
Hematology	511	413	$4.19	3
Pathology	459	443	$4.20	3
Family Practice	389	331	$4.20	12
Nephrology	252	168	$4.22	6
Gastroenterology	186	107	$3.94	1
Nurse Practitioner	143	112	$4.22	6
Physician Assistant	51	51	$4.22	2
Gynecological Oncology	23	18	$4.22	1
Endocrinology	13	12	$4.22	1
Emergency Medicine	11	11	$4.22	1

85044 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
New York	19,620	$4.21	$4.22	106
California	9,815	$4.22	$4.22	12
Florida	5,965	$4.23	$4.22	33
South Carolina	2,678	$4.20	$4.22	13
Georgia	1,076	$4.21	$4.22	7
New Jersey	774	$4.21	$4.22	8
Texas	421	$4.08	$4.22	8
Virginia	414	$4.22	$4.22	2
Pennsylvania	379	$4.21	$4.22	3
Indiana	352	$4.21	$4.22	1
Illinois	232	$4.22	$4.22	4
Missouri	161	$4.18	$4.22	1
Puerto Rico	141	$4.06	$4.22	2
Louisiana	123	$4.22	$4.22	2
Massachusetts	85	$4.22	$4.22	2
Oregon	72	$4.22	$4.22	4
Wisconsin	69	$4.21	$4.22	2
Alabama	57	$4.22	$4.22	2
Ohio	39	$4.22	$4.22	1
Connecticut	24	$4.22	$4.22	1
Washington	22	$4.22	$4.22	1
West Virginia	19	$4.22	$4.22	1

Related codes

85025Complete blood cell count (red cells$7.59
85027Complete blood cell count (red cells$6.33
85045Red blood count$3.90
85018Blood count, hemoglobin$2.31
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
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.