CPT code 85046: Reticulocyte test, additional reticulocyte parameters2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports automated reticulocyte testing with at least one additional cellular measurement, often used to assess marrow response or iron availability.
Medicare pays $5.57 for 85046 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
$5.57
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 85046 covers
This automated blood test measures reticulocytes, immature red blood cells recently released from bone marrow, and includes at least one additional cellular measurement. Depending on the analyzer, the added measurement may reflect reticulocyte hemoglobin content, immaturity, volume, or RNA content. Clinicians use results when evaluating anemia, marrow response, or iron availability. A clinical laboratory typically performs the test on a blood specimen as part of a hematologic evaluation.
Select this code for automated reticulocyte testing that includes one or more additional cellular parameters; automated reticulocyte counting without an added parameter is represented by 85045. The additional parameter or parameters are included in the service represented by this code. Medicare pays the test only under the CLFS. The 2026 national CLFS amount is $5.57, unchanged since 2020; one amount applies nationwide, without locality or office-versus-facility adjustment. The code is excluded from the physician fee schedule by statute.
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 85046
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 85046. 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 85046 with status X (excluded by statute), so the test itself is paid only from the CLFS.
85046 on the lab fee schedule since 2020
85046 · CLFS 2026 Q4 (current)
$5.57
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.
85046 compared with similar tests
- 85045Reticulocyte countAutomated method$3.99
- Choose 85046 when automated reticulocyte testing includes at least one additional cellular parameter; choose 85045 for the automated reticulocyte count alone.
- 85044Reticulocyte countManual method$4.31
- Code 85044 describes a manual reticulocyte count. This code is for automated testing that includes an additional cellular measurement.
- 85025Complete CBCAutomated differential$7.77
- Code 85025 reports a CBC with automated white-cell differential. It does not replace the additional reticulocyte testing represented by this code.
85046 billing questions
When should this code be used instead of 85045?
Use this code when automated reticulocyte testing includes at least one additional cellular measurement. Code 85045 describes an automated reticulocyte count without that added measurement.
What does the additional cellular measurement assess?
Depending on the analyzer, it may reflect reticulocyte hemoglobin content, immaturity, volume, or RNA content.
How does this differ from a manual reticulocyte count?
This code describes automated testing with an additional cellular measurement. Code 85044 is for a manual reticulocyte count.
Can this be reported with a CBC?
A CBC and this test measure different aspects of the blood and may be reported together when both are performed. For example, 85025 reports a CBC with automated differential.
How does Medicare pay this laboratory test?
Medicare pays it under the CLFS at one national amount, with no locality or office-versus-facility adjustment. It is excluded from the physician fee schedule by statute.
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
Fee sheets
Put 85046 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet