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CPT 85027: Complete Blood Count with Hemoglobin and Hematocrit
Headline: CPT code 85027: Complete Blood Count with Hemoglobin and Hematocrit — core laboratory test with broad clinical use
Lead: CPT code 85027 represents the standard complete blood count that quantifies red and white blood cells and platelets and measures hemoglobin and calculates hematocrit in whole blood. It is a foundational laboratory test used across inpatient and outpatient settings for diagnosis, monitoring, and pre-procedural evaluation.
What the code represents and why it matters: CPT code 85027 denotes an automated CBC with hemoglobin and hematocrit measurements. As one of the most frequently ordered lab tests, it supports diagnoses such as anemia, infection, bleeding disorders, and metabolic conditions. Its ubiquity makes it essential to laboratory workflows, billing operations, and clinical decision-making nationally.
Key payers covered: Analysis and benchmarks include major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Overview of reader takeaways: Readers will gain a concise clinical and billing orientation to CPT code 85027, understand its typical sites of service and clinical contexts, and find links to related laboratory codes for differential or automated counts. The publication summarizes payer coverage landscape and coding relationships to support coding accuracy and billing alignment. Data not available in the input for certain payer-specific rates or utilization metrics is noted where applicable.
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Billing Code Overview
CPT code 85027 describes a complete blood count (CBC) with hemoglobin and hematocrit determination performed on a whole blood sample. The procedure includes automated counts of red blood cells, white blood cells, and platelets (thrombocytes), measurement of hemoglobin typically by spectrophotometry, and calculation of hematocrit (packed red cell volume).
Service Type: Laboratory diagnostic testing — complete blood count with Hgb/Hct
Typical Site of Service: Clinical laboratory or hospital laboratory; outpatient phlebotomy collection sites
National Reimbursement Benchmarks
National commercial averages center around BUCA’s mean of $21.30 for CPT 85027, with Blue Cross Blue Shield and Aetna showing the highest top-end variability. Blue Cross Blue Shield has a broad spread between its 75th and 25th percentiles of $14.60 ($36.80 − $21.20), indicating wider commercial rate dispersion, while Aetna’s spread is $6.00 ($10.80 − $5.00). Cigna and UnitedHealth Group display tighter interquartile ranges of $4.20 ($9.20 − $5.00) and $3.70 ($6.50 − $2.80), respectively, suggesting more concentrated pricing around their medians.
Looking at central tendencies, Blue Cross Blue Shield’s mean of $31.50 sits well above BUCA’s average, while Aetna and Cigna have means closer to the BUCA benchmark at $10.20 and $7.50. UnitedHealth Group’s mean of $5.70 is the lowest among named payers. The differing interquartile ranges highlight that Blue Cross Blue Shield and BUCA exhibit wider commercial variability, whereas UnitedHealth Group and Cigna are comparatively tight.