CPT code 85652: Sedimentation rate, automated method2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Automated erythrocyte sedimentation rate testing measures how quickly red blood cells settle and supports evaluation or monitoring of inflammatory conditions.
Medicare pays $2.70 for 85652 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
$2.70
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 85652 covers
This laboratory test measures the rate at which red blood cells settle in a blood sample using an automated method. The result is a nonspecific indicator of inflammation; clinicians may order it when evaluating symptoms such as unexplained fever or joint complaints, or when monitoring an established inflammatory condition.
Report 85652 for the automated test performed; it is distinct from the nonautomated sedimentation-rate test. Medicare pays it only through the CLFS, at one national amount across states and localities, with no office or facility payment difference. The 2026 national CLFS amount is $2.70, unchanged since 2020. The code is excluded from the physician fee schedule, so payment is through the CLFS rather than a separate physician-service 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 85652
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 85652. 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 85652 with status X (excluded by statute), so the test itself is paid only from the CLFS.
85652 on the lab fee schedule since 2020
85652 · CLFS 2026 Q4 (current)
$2.70
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.
85652 compared with similar tests
- 85651Sedimentation rateNonautomated method$4.27
- Both codes measure red-cell sedimentation. Choose 85652 for the automated method and 85651 for the nonautomated method.
- 86140CRP testStandard CRP assay$5.18
- Code 86140 measures C-reactive protein, a different inflammatory marker; 85652 measures how quickly red cells settle.
- 85025Complete CBCAutomated differential$7.77
- Code 85025 reports a complete blood count with differential, not an inflammatory sedimentation-rate result. The tests may be ordered together.
85652 billing questions
When should 85652 be reported instead of 85651?
Use 85652 when the sedimentation rate is performed by an automated method. Code 85651 describes the nonautomated method.
Does 85652 measure a specific disease?
No. It reports a nonspecific measure of inflammation that clinicians interpret alongside the patient's symptoms and other findings.
Can 85652 be reported with a CBC?
Yes, when both tests are ordered and performed. A CBC measures blood cell counts, while 85652 measures red-cell settling.
How does Medicare pay for 85652?
Medicare pays the test under the CLFS at one national rate, 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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