CPT 85025
Complete blood count with differential
A complete blood count with an automated breakdown of white cell types. Ordered for almost every ER visit involving infection, bleeding, or unexplained symptoms. The version without the differential is 85027.
Billed to Medicare
$32
What providers submitted, on average, for this code in a hospital setting.
Medicare accepted
$8
What Medicare treated as payable. Not a commercial rate or a cash price.
The gap
4.2x
How many times the accepted amount the billed figure was.
National averages from the Centers for Medicare & Medicaid Services, 2024 data, retrieved 2026-09-14. Medicare fee-for-service, physician and practitioner claims only. The hospital's own charge for the same code is separate and is usually higher. Based on 10,685 services.
Among the 10 lab tests codes on this site with CMS figures, this gap ranks 4 of 10 (median 3.7x). The widest is Urinalysis, automated with microscopy at 5.5x.
Where this line goes wrong
With and without on the same draw
85025 includes everything in 85027. Both billed together is a duplicate.
Manual differential on top
A manual differential (85007) is sometimes legitimately added when the automated count flags something, but it should have its own result in the lab report.
Check it, then ask
- 1
Ask for the itemized bill and the lab results and match every billed test to a result.
- 2
Check for a panel billed alongside one of its own components, or two overlapping panels on the same draw.
- 3
Count the blood draw (36415) lines; one per visit is the norm.
- 4
If self-pay, ask for the hospital's cash price for each test, or compare with an independent lab's published price.
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People also ask
What does a CBC with differential test for?
Red cells, white cells, platelets and haemoglobin, plus the proportions of each white cell type. It is a general screening test rather than a test for one condition.
Sources
This page explains a billing code in general terms. It is not a coding, legal or medical opinion about your bill, and the code descriptions are mediloop's own plain-English summaries, not the official CPT descriptors, which are owned by the American Medical Association. Whether a charge was correct depends on the record of your visit and your payer's rules.