CPT 85396 Pathology/Laboratory
Clotting assay whole blood Cost
Body System: General
Medicare Facility Rate
$16
CMS PFS CY2026
Medicare Non-Facility Rate
$16
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.36
Work RVU
0.09
Facility PE RVU
0.02
Malpractice RVU
0.47
Total RVU
Frequently Asked Questions
How much does Clotting assay whole blood cost?
The Medicare facility rate is $16. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Clotting assay whole blood cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $16.