How much does Medicare pay for CPT 85302?

Medicare allowed an average of $11.75 per service and paid $11.75 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $205.35, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 85302?

Protein c, (clotting inhibitor) activity. It was billed 7,139 times to 6,996 Medicare beneficiaries by 46 providers in 2024.

Which specialty bills 85302 most?

Clinical Laboratory, with 7,139 services from 46 clinicians.

CPT 85302

Protein c, (clotting inhibitor) activity

$11.75Medicare-allowed amount per service, averaged across 7,139 services

Providers submitted

$205.35

Asking price, not received

Medicare allowed

$11.75

The fee schedule figure

Medicare paid

$11.75

Balance is patient coinsurance

Providers submitted an average of $205.35 for this code and Medicare allowed $11.75 — 17.5× 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 $11.75 (100%); the rest is the patient’s coinsurance and deductible.

Services: 7,139
Beneficiaries: 6,996
Providers billing it: 46
Total allowed: $83,883

What Medicare pays for CPT 85302

Across 7,139 services billed by 46 providers to 6,996 beneficiaries, Medicare allowed an average of $11.75 per service. 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 85302

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	7,139	6,996	$11.75	46

85302 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
North Carolina	1,613	$11.77	$11.77	3
New Jersey	1,486	$11.72	$11.77	3
Arizona	1,029	$11.75	$11.77	2
Texas	862	$11.77	$11.77	6
Florida	728	$11.77	$11.77	3
California	361	$11.71	$11.77	5
Georgia	146	$11.77	$11.77	1
Tennessee	141	$11.77	$11.77	1
Nevada	107	$11.77	$11.77	1
Colorado	104	$11.77	$11.77	3
Kansas	99	$11.68	$11.77	3
Alabama	81	$11.65	$11.77	2
Illinois	65	$11.77	$11.77	1
Massachusetts	63	$11.77	$11.77	2
Pennsylvania	48	$11.77	$11.77	2
Virginia	44	$11.77	$11.77	1
Ohio	43	$11.77	$11.77	1
Utah	34	$11.77	$11.77	1
New York	26	$11.77	$11.77	1
Maryland	20	$11.77	$11.77	1
Minnesota	16	$11.77	$11.77	1
Wisconsin	12	$11.77	$11.77	1
Washington	11	$11.77	$11.77	1

Related codes

85379Coagulation function measurement$9.96
85384Fibrinogen (factor 1) activity measurement$9.52
85390Coagulation function screening test$33.93
85306Protein s (clotting inhibitor) measurement$14.99
85385Fibrinogen (factor 1) antigen detection$14.16
85303Protein c antigen (clotting inhibitor) measurement$13.54
85300Antithrombin iii antigen (clotting inhibitor) activity$11.60
85305Protein s (clotting inhibitor) level$11.36
85307Activated protein resistance assay$14.99
85301Antithrombin iii antigen (clotting inhibitor) level$10.58
85347Coagulation time measurement$4.18
85362Coagulation function analysis$6.73

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.