85027

Complete blood cell count (red cells, white blood cell, platelets), automated test

Medicare pricing data for 19,692 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 3.3 million services annually. Even small pricing inefficiencies here affect millions of patients. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Complete blood cell count (red cells, white blood cell, platelets), automated test (HCPCS code 85027) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $6.33, but hospitals typically charge $31.19 — a 4.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.27

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $6.33, your out-of-pocket cost would be approximately $1.27. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$6.33
Average Hospital Charge
$31.19
Markup Ratio
4.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$31.19
Medicare Allowed$6.33
Medicare Payment$6.33

Hospitals charge 4.9x more than what Medicare allows for this procedure. Medicare actually pays $6.33 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$6$1474,168+0.2%
District of Columbia$6$259161+0.2%
Florida$6$35324287,730+0.2%
Massachusetts$6$32927154,520+0.2%
Missouri$6$3131625,610+0.2%
Nevada$6$343024,112+0.2%
New Mexico$6$262814,713+0.2%
Rhode Island$6$31126,590+0.2%
Utah$6$171946,460+0.2%
California$6$33519336,365+0.2%
Illinois$6$39659102,8580.0%
Kansas$6$3421595,3930.0%
Kentucky$6$1912414,3990.0%
Louisiana$6$2517020,5940.0%
Maryland$6$2727655,6980.0%
Michigan$6$179420,3410.0%
New Hampshire$6$241213,3780.0%
New Jersey$6$32348374,5950.0%
New York$6$3466995,9220.0%
North Carolina$6$291,167290,9850.0%
Ohio$6$25457144,7680.0%
Oklahoma$6$276923,0900.0%
Pennsylvania$6$4026364,1660.0%
Texas$6$321,266182,9130.0%
Vermont$6$30671,7280.0%
Virginia$6$23667104,8520.0%
Wyoming$6$38712,6150.0%
Alaska$6$461371,9790.0%
Arizona$6$21288133,3980.0%
Colorado$6$2914025,2080.0%
Connecticut$6$302107,7370.0%
Georgia$6$3532069,481-0.2%
Indiana$6$1924215,578-0.2%
Maine$6$191499,707-0.2%
Nebraska$6$2029730,703-0.2%
Alabama$6$2918767,361-0.2%
Hawaii$6$201113,731-0.3%
Montana$6$29322,973-0.3%
North Dakota$6$441445,311-0.3%
Oregon$6$2129721,751-0.3%
South Carolina$6$3354256,849-0.3%
South Dakota$6$321849,145-0.3%
Tennessee$6$271,02874,267-0.3%
Washington$6$2883374,443-0.3%
Arkansas$6$2520012,047-0.3%
Idaho$6$33532,202-0.5%
Iowa$6$2733726,361-0.5%
Minnesota$6$322,91688,007-0.5%
West Virginia$6$30743,285-0.5%
Wisconsin$6$661,59764,967-0.5%
Mississippi$6$3623618,648-0.6%
Puerto Rico$6$71396,522-0.6%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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