CPT code 85045: Reticulocyte count, automated method2026 Medicare lab fee · Clinical Laboratory Fee Schedule
An automated blood test that counts reticulocytes, used to assess red blood cell production during evaluation or monitoring of anemia and marrow response.
Medicare pays $3.99 for 85045 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
$3.99
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 85045 covers
An automated reticulocyte count measures immature red blood cells in a blood specimen. Reticulocytes reflect recent red blood cell production, so clinicians may order the test when evaluating anemia or monitoring marrow response to treatment, blood loss, or recovery from marrow suppression. A clinical laboratory performs the automated test, which may be ordered alongside a complete blood count for a broader blood-cell assessment.
Report this code for an automated reticulocyte count, rather than a manual count or an automated count that also includes reticulocyte hemoglobin content. Medicare pays 85045 under the CLFS at one national amount in every locality, with no office or facility payment difference. The 2026 national CLFS amount is $3.99, unchanged since 2020. The test is paid only from the CLFS and is excluded from the physician fee schedule.
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 85045
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 85045. 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 85045 with status X (excluded by statute), so the test itself is paid only from the CLFS.
85045 on the lab fee schedule since 2020
85045 · CLFS 2026 Q4 (current)
$3.99
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.
85045 compared with similar tests
- 85044Reticulocyte countManual method$4.31
- Use 85045 for an automated reticulocyte count and 85044 when the count is performed manually.
- 85046Reticulocyte testAdditional reticulocyte parameters$5.57
- 85045 reports an automated reticulocyte count; 85046 includes reticulocyte hemoglobin content with the automated count.
- 85025Complete CBCAutomated differential$7.77
- 85025 reports a complete blood count with automated white-cell differential. It does not substitute for the separate automated reticulocyte count reported with 85045.
- 85027Complete CBCWithout automated differential$6.47
- 85027 reports an automated complete blood count without a differential. Report 85045 separately when an automated reticulocyte count is performed.
85045 billing questions
When should I report 85045 instead of 85044?
Report 85045 when the reticulocyte count is performed using an automated method. Use 85044 for a manual reticulocyte count.
Does a CBC include the reticulocyte count?
A CBC code such as 85025 or 85027 does not represent the reticulocyte count. Report 85045 when the automated reticulocyte test is also performed.
How does 85045 differ from 85046?
85045 reports an automated reticulocyte count. 85046 reports an automated reticulocyte count that includes reticulocyte hemoglobin content.
How does Medicare pay for 85045?
Medicare pays 85045 through the CLFS at one national amount, regardless of locality or office versus facility setting. It is excluded from the physician fee schedule.
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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