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CBC without differential (CPT 85027): what Medicare pays

On a hospital bill, CPT 85027 is the code for: Complete blood cell count (red cells, white blood cell, platelets), automated test. Here is what Medicare pays for it, what is billed on average, and how to question the line on your bill.

CPT 85027 at a glance

Medicare average allowed amount$6.33
Average amount billed to Medicare$31.99
Billed vs. allowed5.1 times
Services in the data3,329,922
Setting and yearOffice or clinic, national average, 2024

On a hospital bill a patient shared publicly in 2026, this line was billed $496.83.

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What this code is

This is a group of laboratory tests done on one blood sample and billed under a single code.

Why your hospital bill can show more

Medicare pays a national amount for each code. Hospitals set their own list prices, called the chargemaster, so a hospital bill can show a much higher amount for the same code. In a hospital or an emergency room, a separate facility charge is often added. Medicare's amount is not a price the hospital must accept, but it is a fair reference to negotiate.

Common billing problems with CPT 85027

Billed twice on the same day

The same code, on the same day and at the same price, can appear twice. Sometimes it is real (a second sample, the other side, mother and baby). Ask for the time and the reason of each one, and ask them to remove the extra charge if it was done once.

A test billed on top of its panel

A panel already includes its single tests. If the bill also lists one of those tests on the same day, ask them to remove it, unless it came from a separate blood draw.

No code on the line

If your bill shows a total without codes, ask for a fully itemized bill. Without codes, nobody can check the charges.

How to question this charge

  1. Ask the hospital for a fully itemized bill, with the code, date, quantity and price of every line.
  2. Compare the line with the Medicare amount above.
  3. Ask in writing for a fair price, the lowest amount they will accept, and any discount for paying in full or for patients without insurance.
  4. Ask for the hospital's financial assistance policy.

BillCheck reads a photo of your bill on your phone, compares every line and writes the letter. Check my bill.

Related codes

Frequently asked questions

How much does CPT 85027 cost?

It depends on where it is done. In 2024, Medicare's average allowed amount for CPT 85027 in an office setting was $6.33, and providers billed Medicare $31.99 on average. Hospitals can bill more. If you have no insurance, ask for the self-pay price before you pay.

Can I be billed twice for CPT 85027 on the same day?

Only if it was really done twice. Ask for the time and the reason of each line. If it was done once, ask them to remove the extra charge.

What is the difference between CPT 85027 and CPT 85025?

CPT 85027 is CBC without differential. CPT 85025 is CBC with differential. Medicare's average allowed amounts were $6.33 and $7.59 in 2024.

How do I question this charge?

Ask for an itemized bill, compare the line with the Medicare amount, then ask in writing for a fair price and for financial assistance. BillCheck writes the letter for you.

Sources

  1. CMS, Medicare Physician & Other Practitioners by Geography and Service, 2024: national averages, office setting.
  2. IRS, financial assistance policy of nonprofit hospitals, section 501(r)(4).