CPT code 85009: Manual WBC differential, buffy coat method2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Manual buffy coat white cell differential testing classifies leukocytes when a clinician needs a manual evaluation of the patient’s white blood cell distribution.
Medicare pays $5.07 for 85009 under the 2026 Clinical Laboratory Fee Schedule: one national amount, the same in every state and setting.
Medicare lab fee · CLFS 2026 Q4
National CLFS amount
$5.07
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2020
- Unchanged
- CMS updates
- Quarterly
Medicare pays the lesser of the lab’s charge and this amount. Patients usually owe no Part B deductible or coinsurance for covered clinical lab tests.
On this page 8 sections
What 85009 covers
This test manually evaluates the types of white blood cells in a buffy coat prepared from a blood specimen. The concentrated leukocytes are examined and classified, providing a manual differential for evaluation of leukocyte abnormalities. Clinical laboratories perform the test when a clinician requests this manual assessment.
Report 85009 for the manual differential performed using a buffy coat preparation. It identifies the differential service, not a count for each cell type. The reported result is a manual differential of buffy-coat white cells, not an automated differential or a smear interpretation. Medicare pays 85009 only through the CLFS; the 2026 national amount is $5.07, unchanged since 2020. The CLFS amount is the same across localities, with no geographic or office-versus-facility adjustment.
This summary was written with AI assistance from CMS Clinical Laboratory Fee Schedule data. Amounts on this page come directly from CMS files.
How Medicare pays 85009
Clinical lab tests aren’t priced like physician services. They’re paid from their own fee schedule, with its own rules. See the whole lab fee schedule.
One national amount
CMS sets a single Clinical Laboratory Fee Schedule amount for 85009. There’s no geographic (GPCI) adjustment, so it pays the same in every state and payment locality.
No office or facility rate
Lab tests aren’t built from relative value units, so there’s no office and facility split: the place of service doesn’t change the CLFS amount.
Updated every quarter
CMS republishes the CLFS each quarter. New tests, often proprietary laboratory analyses (PLA codes), join during the year; existing amounts are updated each January.
Excluded from the physician fee schedule
The physician fee schedule lists 85009 with status X (excluded by statute), so the test itself is paid only from the CLFS.
85009 on the lab fee schedule since 2020
85009 · CLFS 2026 Q4 (current)
$5.07
Unchanged since Jan 1, 2020
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
85009 compared with similar tests
- 85004WBC differentialAutomated count$6.47
- 85004 is for an automated white cell differential. Choose 85009 when the differential is evaluated manually using a buffy coat preparation.
- 85007Manual differentialMicroscopic white cell count$3.80
- 85007 describes a manual differential performed with a blood smear. 85009 identifies the buffy coat method.
- 85025Complete CBCAutomated differential$7.77
- 85025 reports a complete CBC with an automated differential. 85009 reports only the manual buffy coat differential.
- 85027Complete CBCWithout automated differential$6.47
- 85027 reports a complete automated CBC without a differential. 85009 identifies the manual buffy coat differential.
85009 billing questions
How does 85009 differ from 85007?
Both involve a manual white cell differential, but 85009 is for evaluation using a buffy coat preparation. 85007 describes a blood-smear method.
When should 85009 be chosen over 85004?
Use 85009 for a manual differential using a buffy coat. Use 85004 when the white cell differential is automated.
Does 85009 include a complete CBC?
No. It reports manual differential evaluation of buffy-coat white cells, not a complete CBC.
Is 85009 reported per white cell type?
No. The code identifies the manual differential service, not a separate count for each leukocyte type.
How does Medicare pay for 85009?
Medicare pays the test through the CLFS. The national amount applies across localities and does not vary between office and facility settings.
Where this amount comes from
FeeBase reads lab amounts directly from the CMS Clinical Laboratory Fee Schedule file for the quarter: one row per code, with its payment indicator and national amount. Contractor-priced tests are labeled, never given a made-up amount. Amounts are Medicare payment limits, not a patient’s bill or a commercial rate.
CMS CLFS 2026 Q4 · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file line behind this amount
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