CPT code 85027: Complete CBC, without automated differential2026 Medicare lab fee · Clinical Laboratory Fee Schedule
An automated complete blood count measures red cells, white cells, and platelets without a white-cell differential, commonly to assess anemia or blood-cell changes.
Medicare pays $6.47 for 85027 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
$6.47
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 85027 covers
This laboratory test measures red blood cells, white blood cells, and platelets using an automated method. The reported CBC also includes hemoglobin and hematocrit. It is commonly ordered from a whole-blood specimen to evaluate or monitor anemia, infection, bleeding, and other conditions affecting blood-cell counts. Hospital laboratories and independent or clinic-based laboratories commonly perform the test for outpatient and facility patients.
Report one CBC when the automated count is performed without a white-cell differential. When an automated differential is part of the CBC, use the code for a complete CBC with differential instead. Medicare pays this test only through the CLFS. The 2026 national CLFS amount is $6.47, unchanged since 2020; the same amount applies in every locality, without an office or facility adjustment. The test has no separate physician-fee-schedule payment.
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 85027
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 85027. 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 85027 with status X (excluded by statute), so the test itself is paid only from the CLFS.
85027 on the lab fee schedule since 2020
85027 · CLFS 2026 Q4 (current)
$6.47
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.
85027 compared with similar tests
- 85025Complete CBCAutomated differential$7.77
- 85025 reports an automated complete CBC with a white-cell differential; 85027 is for the complete count without the differential.
- 85004WBC differentialAutomated count$6.47
- 85004 is an automated white-cell differential count, not a complete CBC. For a CBC performed with an automated differential, use 85025.
- 85018HemoglobinHemoglobin only$2.37
- 85018 reports hemoglobin alone. Choose 85027 when the laboratory performs the complete automated blood count.
- 85049Platelet countAutomated method$4.48
- 85049 reports an automated platelet count alone; 85027 includes platelets as part of a complete CBC.
85027 billing questions
When should 85027 be reported instead of 85025?
Use 85027 for an automated complete blood count without a white-cell differential. Use 85025 when the automated CBC includes a differential.
Does 85027 include a white-cell differential?
No. It includes the red-cell, white-cell, and platelet counts, but not a differential of white-cell types.
How many units are reported?
Report one unit for each complete CBC performed.
How does Medicare pay for 85027?
Medicare pays the test through the CLFS at one national amount, with no locality or office-versus-facility adjustment. The physician fee schedule does not provide a separate payment for it.
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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