How much does Medicare pay for CPT 85045?

Medicare allowed an average of $3.90 per service and paid $3.90 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $36.78, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 85045?

Red blood count, automated test. It was billed 322,609 times to 241,829 Medicare beneficiaries by 1,094 providers in 2024.

Which specialty bills 85045 most?

Clinical Laboratory, with 271,523 services from 269 clinicians. Next are Hematology-Oncology, Medical Oncology, Internal Medicine.

CPT 85045

Red blood count, automated test

$3.90Medicare-allowed amount per service, averaged across 322,609 services

Providers submitted

$36.78

Asking price, not received

Medicare allowed

$3.90

The fee schedule figure

Medicare paid

$3.90

Balance is patient coinsurance

Providers submitted an average of $36.78 for this code and Medicare allowed $3.90 — 9.4× 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 $3.90 (100%); the rest is the patient’s coinsurance and deductible.

Services: 322,609
Beneficiaries: 241,829
Providers billing it: 1,094
Total allowed: $1,258,175

What Medicare pays for CPT 85045

Across 322,609 services billed by 1,094 providers to 241,829 beneficiaries, Medicare allowed an average of $3.90 per service. That is 1.3 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 85045

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	271,523	204,354	$3.90	269
Hematology-Oncology	28,466	20,834	$3.90	411
Medical Oncology	7,977	5,482	$3.90	132
Internal Medicine	5,639	4,190	$3.88	130
Pathology	3,763	2,959	$3.90	21
Family Practice	2,149	1,747	$3.89	57
Nurse Practitioner	1,081	789	$3.90	32
Hematology	917	596	$3.89	8
Physician Assistant	413	292	$3.89	14
Gastroenterology	127	110	$3.91	1
General Practice	121	112	$3.85	2
Endocrinology	108	87	$3.91	2
Rheumatology	77	66	$3.87	4
Nephrology	61	53	$3.91	3
Emergency Medicine	49	44	$3.91	2

85045 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 Jersey	57,030	$3.91	$3.91	25
California	40,758	$3.90	$3.91	57
Florida	37,870	$3.90	$3.91	172
North Carolina	27,270	$3.91	$3.91	36
Texas	26,972	$3.90	$3.91	139
New York	14,583	$3.91	$3.91	73
Arizona	12,274	$3.91	$3.91	14
Alabama	11,452	$3.90	$3.91	18
Illinois	11,080	$3.91	$3.91	66
Ohio	10,729	$3.90	$3.91	25
Tennessee	10,490	$3.90	$3.91	93
Georgia	8,348	$3.91	$3.91	23
Massachusetts	5,839	$3.91	$3.91	24
Kansas	5,125	$3.91	$3.91	8
Washington	4,308	$3.91	$3.91	14
Nevada	3,952	$3.90	$3.91	32
Maryland	3,757	$3.90	$3.91	18
Pennsylvania	3,696	$3.91	$3.91	9
Virginia	3,164	$3.90	$3.91	28
Minnesota	2,840	$3.89	$3.91	13
Oklahoma	2,649	$3.90	$3.91	11
Missouri	2,188	$3.90	$3.91	11
Michigan	2,159	$3.90	$3.91	16
Hawaii	1,817	$3.90	$3.91	2
Oregon	1,462	$3.90	$3.91	12
Nebraska	1,203	$3.90	$3.91	24
South Carolina	1,182	$3.89	$3.91	10
Colorado	1,107	$3.90	$3.91	7
Louisiana	1,023	$3.88	$3.91	11
Indiana	1,001	$3.86	$3.91	15
Rhode Island	826	$3.88	$3.91	1
Kentucky	688	$3.88	$3.91	5
Connecticut	627	$3.88	$3.91	9
Mississippi	602	$3.85	$3.91	8
Arkansas	576	$3.90	$3.91	19
Wisconsin	468	$3.89	$3.91	10
Utah	370	$3.90	$3.91	10
Iowa	367	$3.91	$3.91	12
Maine	298	$3.90	$3.91	2
New Mexico	235	$3.89	$3.91	2
Montana	59	$3.91	$3.91	2
South Dakota	44	$3.91	$3.91	1
Delaware	31	$3.91	$3.91	2
Idaho	28	$3.91	$3.91	1
North Dakota	22	$3.91	$3.91	1
New Hampshire	16	$3.91	$3.91	1
Wyoming	12	$3.91	$3.91	1
Puerto Rico	12	$3.91	$3.91	1

Related codes

85025Complete blood cell count (red cells$7.59
85027Complete blood cell count (red cells$6.33
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
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.