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CPT 85025: Complete Blood Count (CBC)
CPT code 85025 designates a complete blood count (CBC), a routine laboratory test that measures cellular components of blood and informs diagnosis and management of anemia, infection, and other systemic conditions. As one of the most frequently ordered hematology assays in clinical practice, the CBC has national significance for clinical workflows, utilization management, and laboratory reimbursement.
This publication covers major payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, typical sites where the test is performed, and clinical contexts in which a CBC is ordered. The report highlights payer coverage considerations and common billing interactions tied to panel testing, including bundling relationships with broader metabolic or health panels.
The content provides practical, nonprescriptive information on coding scope and clinical relevance: what payers are included in the assessment, how the service is typically delivered, and what benchmarks or policy updates may affect claims processing and clinical documentation. Data not provided in the input are noted where applicable. The goal is to clarify the code’s clinical role and billing context for administrators, clinicians, and revenue cycle staff working at a national level.
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Billing Code Overview
CPT code 85025 represents a complete blood count (CBC), a laboratory test that quantifies and characterizes different cell types in a patient’s blood. The procedure involves drawing venous blood into an anticoagulant-containing tube and processing the specimen, most commonly using an automated hematology analyzer, to produce a cell count and related parameters for clinician review.
Service Type: Clinical laboratory hematology test
Typical Site of Service: Clinical laboratory or hospital outpatient laboratory; blood draw may occur in ambulatory clinic, physician office, or phlebotomy collection site.
National Reimbursement Benchmarks
For CPT 85025, the BUCA average commercial benchmark sits at $23.80, framing the broader market midpoint. Blue Cross Blue Shield displays the highest central tendency with a median of $29.60 and a high degree of upside (max $141.40), while Aetna and Cigna show lower medians ($9.00 and $7.60 respectively). UnitedHealth Group’s median is $4.70, placing it at the lower end of common contract levels.
Examining dispersion (P75–P25) highlights where rates cluster or spread: Blue Cross Blue Shield’s interquartile range is $15.0 ($39.10–$26.10), indicating the widest middle spread among listed payers; Aetna’s IQR is $11.8 ($18.40–$6.20). UnitedHealth Group is the tightest with an IQR of $4.3 ($7.80–$3.50). BUCA’s IQR is $9.0 ($27.60–$17.00), reflecting moderate commercial variability around its $23.80 mean.