What's a fair price for CPT 85025?

Most patients should expect to pay no more than 2–3× the Medicare allowable for the same service. Medicare's allowable rate for 85025 is roughly $11, which is a useful fair-price anchor. A reasonable target when negotiating cash-pay or self-pay is somewhere between the Medicare rate and the in-network allowed amount your insurer would pay.

How do I dispute CPT 85025?

Request a fully itemized bill with CPT codes and your EOB. For 85025 specifically, the most common issues are unbundling, duplicate. Write a short dispute letter to the provider's billing office listing the specific line items you're contesting and the reason; federal and state law require them to investigate and pause collections while the dispute is open. Or upload the bill to patientbill.org and we'll do the dispute letter for you — we only get paid if we lower your bill.

Why is CPT 85025 on my bill?

Complete blood count (CBC) with differential. It appears on bills when a service was performed in a lab setting and the provider documented enough work to support this specific code. If the description doesn't match what you remember happening at your visit, ask for the chart note that supports the code.

CPT code

85025 — Complete blood count (CBC) with differential

Plain-English reference for CPT 85025. What it covers, what it typically costs, and the billing errors patientbill.org looks for on this code.

Typical setting: Lab
Medicare allowable: $11
Common private-payer range: $30 – $200

The Medicare allowable is the national non-facility rate from the CMS Physician Fee Schedule and is the most defensible "fair price" anchor. Commercial charges typically run 2–5× this number; hospital list prices can be much higher still.

What this code actually is

CPT 85025 is the CBC with automated differential — the standard 'blood count' test. Frequently unbundled (CBC without differential is 85027). Also a common duplicate when the same blood draw is ordered by multiple providers in an ED visit.

Audit issues we look for on 85025

Unbundling — individual sub-tests billed separately when they should be one panel charge
Duplicate billing — the same service charged more than once

Think your bill has the wrong 85025 charge?

Upload the bill and we'll check for upcoding, unbundling, duplicates, and prices above what's reasonable. If we recover money for you, we keep a small contingency fee. If we don't, you owe nothing.

Common questions about CPT 85025

Private-payer charges typically fall in the $30 – $200 range, though hospital list prices can run much higher. Medicare's allowable rate for 85025 is roughly $11, which is a useful fair-price anchor. If your bill for this code is significantly above the high end of that range, ask for an itemized statement and compare against your Explanation of Benefits (EOB) — the insurance "allowed amount" is the most defensible reference point.

Related codes in Lab panels & blood tests

Patientbill.org is not affiliated with any provider, insurer, or the AMA. Code descriptions are CMS-published short descriptors plus our own plain-English explanations; pricing references are from the CMS Medicare Physician Fee Schedule and public charge benchmarks and may be outdated. Verify your specific charges against your EOB.