CPT code 85705: Inhibition test, circulating anticoagulant2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures tissue thromboplastin inhibition associated with a circulating anticoagulant and is reported when this specific coagulation assay is performed.
Medicare pays $9.63 for 85705 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
$9.63
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 85705 covers
Code 85705 identifies measurement of tissue thromboplastin inhibition associated with a circulating anticoagulant. It is a specific coagulation assay, distinct from a partial thromboplastin time result. A clinician may order it while evaluating a suspected circulating anticoagulant, and a clinical laboratory reports the inhibition measurement after performing the test. The result concerns inhibition involving tissue thromboplastin; it is not a routine clotting-time result or a general coagulation panel. Codes 85730 and 85732 identify partial thromboplastin time testing, so they represent different laboratory services.
Medicare pays 85705 through the CLFS at one national amount per code, with the same amount in every state and locality and no office or facility difference. The 2026 national amount is $9.63, unchanged since 2020. The test is excluded from the physician fee schedule by statute and is paid through the CLFS.
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 85705
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 85705. 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 85705 with status X (excluded by statute), so the test itself is paid only from the CLFS.
85705 on the lab fee schedule since 2020
85705 · CLFS 2026 Q4 (current)
$9.63
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.
85705 compared with similar tests
- 85730Partial thromboplastin timePTT, plasma or whole blood$6.01
- 85730 identifies partial thromboplastin time testing. Use 85705 for the tissue thromboplastin inhibition measurement, not for a routine clotting-time result.
- 85732PTT studyPlasma fraction substitution$6.47
- 85732 identifies manual partial thromboplastin time testing. It is distinct from the tissue thromboplastin inhibition assay reported with 85705.
- 85613Viper venom testDiluted clotting assay$9.58
- 85613 identifies Russell viper venom time testing, a different coagulation assay used in evaluating circulating anticoagulants; 85705 measures tissue thromboplastin inhibition.
85705 billing questions
How does 85705 differ from a partial thromboplastin time?
Code 85705 measures tissue thromboplastin inhibition associated with a circulating anticoagulant. Codes 85730 and 85732 identify partial thromboplastin time testing.
Can 85705 and a partial thromboplastin time be reported together?
They identify different tests. Report each when it was performed and documented; a partial thromboplastin time is not a substitute for the inhibition assay.
What documentation supports reporting 85705?
Document the tissue thromboplastin inhibition measurement performed and its clinical role in evaluating a suspected circulating anticoagulant.
How does Medicare pay for 85705?
Medicare pays the test through the CLFS at one national amount per code across localities, with no office or facility difference. 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
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