CPT code 85730: Partial thromboplastin time, PTT, plasma or whole blood2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures how long blood takes to clot through the intrinsic and common pathways, supporting evaluation of bleeding disorders and monitoring of heparin therapy.
Medicare pays $6.01 for 85730 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
$6.01
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 85730 covers
The partial thromboplastin time (PTT) measures the time required for a blood sample to clot after reagents activate the clotting process. Clinical laboratories perform the test on plasma or whole blood. It is commonly ordered to investigate abnormal bleeding or coagulation results, assess suspected clotting-factor deficiencies, and monitor unfractionated heparin therapy. Clinicians interpret the result in context of other coagulation testing and anticoagulant exposure.
Report 85730 when the PTT test is performed. Medicare pays it only through the Clinical Laboratory Fee Schedule (CLFS). The 2026 national CLFS amount is $6.01, unchanged from 2020 through 2026. One national amount applies in every state and locality, without geographic or office-versus-facility adjustment. The code 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 85730
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 85730. 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 85730 with status X (excluded by statute), so the test itself is paid only from the CLFS.
85730 on the lab fee schedule since 2020
85730 · CLFS 2026 Q4 (current)
$6.01
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.
85730 compared with similar tests
- 85732PTT studyPlasma fraction substitution$6.47
- 85730 is for PTT; 85732 is for activated PTT (APTT). Select the code that matches the test performed.
- 85610Prothrombin timeRoutine coagulation test$4.29
- 85610 reports prothrombin time, a different coagulation test. It may be ordered with PTT, but it does not replace 85730.
- 85705Inhibition testCirculating anticoagulant$9.63
- 85705 is a thromboplastin inhibition test, not the routine partial thromboplastin time reported with 85730.
85730 billing questions
When should 85730 be used instead of 85732?
Use 85730 for a partial thromboplastin time (PTT). Code 85732 identifies the activated partial thromboplastin time (APTT); follow the test actually performed and reported by the laboratory.
Can 85730 be reported with a prothrombin time?
PTT and prothrombin time assess different parts of the coagulation process and may be ordered together. Report 85610 when the prothrombin time is performed.
What specimen types are included?
Code 85730 covers PTT testing on plasma or whole blood.
Does Medicare pay 85730 under the physician fee schedule?
No. Medicare pays this test through the CLFS, using one national amount across localities and care settings.
What should the laboratory record support?
Documentation should identify the PTT performed, the specimen, and the result. The record should support the reason for testing, such as evaluation of a coagulation abnormality or heparin monitoring.
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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