CPT 85025: Complete Blood Count (CBC) with Automated Differential
CPT 85025 is a complete blood count with automated differential WBC count and platelet count. It bundles the CBC indices plus a 5-part white cell differential. As a clinical laboratory test it is priced under the Medicare Clinical Laboratory Fee Schedule (CLFS), not the Physician Fee Schedule, so it has no PFS dollar amount.
- Code type
- Clinical laboratory panel (hematology)
- Priced under
- Medicare Clinical Laboratory Fee Schedule (CLFS), not the PFS
- Components
- CBC indices + platelets + 5-part automated differential
- Frequency notes
- Diagnosis-driven; 85027 is a component and cannot be billed with it
What is CPT 85025 used for?
CPT 85025 reports a complete blood count (CBC) with automated differential — the standard CBC indices, a platelet count, and a machine-generated 5-part white blood cell differential in one bundled test. It is among the most-ordered hematology tests, used for anemia workups, infection evaluation, and routine health screening.
The presence of the automated differential is what makes this 85025 rather than 85027. Order documentation should specify a differential ("CBC with diff" or "CBC w/ auto diff") to support the code.
How much does Medicare pay for 85025?
On the Physician Fee Schedule, 85025 carries status indicator X — statutory exclusion, so no RVUs and no PFS dollar. That is correct: lab tests are not paid on the PFS.
Payment comes from the Medicare Clinical Laboratory Fee Schedule (CLFS), which prices lab codes with national limitation amounts and gapfill/crosswalk methodology. The Medicare fee calculator PFS lookup returns nothing for 85025 — use the current CLFS rate from your MAC or payer fee file.
What is included in 85025?
The single bundled code covers all of the following:
| Group | Included measurements |
|---|---|
| Red cells | Hemoglobin, hematocrit, RBC, MCV, MCH, MCHC, RDW |
| White cells | Total WBC + 5-part automated differential |
| Platelets | Platelet count |
How do bundling rules apply to 85025?
Example: a lab bills 85025 and also 85027 on the same date. Because 85027 (CBC without differential) is a component of 85025, NCCI bundles it and the payer denies the extra line. Reporting a separate automated differential code alongside 85025 is likewise unbundling.
- Order specifies a differential → bill 85025.
- Order says only "CBC" → bill 85027, not 85025.
- Never report 85025 and 85027 together on one claim.
Coverage follows payer medical-necessity rules and repeat testing can hit MUE limits, so watch units per day and diagnosis support. Check stray edits with the NCCI tables.
Frequently asked questions
Because 85025 is a clinical laboratory test, not a physician service. On the PFS it carries status indicator X (statutory exclusion) and is never paid there. Payment comes from the Clinical Laboratory Fee Schedule (CLFS) using national limitation amounts and gapfill/crosswalk pricing. A $0 on the PFS is the expected result, not a denial.
85025 is a CBC with an automated 5-part white blood cell differential; 85027 is a CBC without the differential. If the order says "CBC with diff," bill 85025. If it says only "CBC," bill 85027. Because 85027 is a component of 85025, the two cannot be reported together on the same claim.
The differential is a machine-generated 5-part breakdown of white cells — neutrophils, lymphocytes, monocytes, eosinophils, and basophils — on top of the standard CBC indices (hemoglobin, hematocrit, RBC, WBC, platelets, MCV, MCH, MCHC, RDW). That differential is the element distinguishing 85025 from 85027 and from a manual differential.
Sources & further reading
Reviewed by the ImmediCare Solutions RCM team
Certified billers and coders handling claims across 50+ specialties nationwide. This entry is reviewed against current payer policy and CMS rules. Last review: Jul 5, 2026.
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