Code Reality Check
85025 reimbursement rate: CBC w/ differential, automated
CBC w/ differential, automated (CPT 85025) pays a median $12.09 in North Carolina and $4.37 in Rhode Island, against a Medicare anchor of $9.43. 50 of 51 states clear the publication floor.
spread 2.8x top to bottom
Medicare anchor $9.43
50/51 states published
The 50-state spread
as of 2026-07-15| State | Median | vs Medicare | Band | Rate points | Tier |
|---|---|---|---|---|---|
| North Carolina | $12.09 | 1.28x | $10–$23 · P90 $23 | 142,664 | Benchmark |
| South Carolina | $10.07 | 1.07x | $7–$12 · P90 $23 | 8,212 | Benchmark |
| Wisconsin | $9.32 | 0.99x | $6–$30 · P90 $58 | 31,311 | Benchmark |
| Wyoming | $8.58 | 0.91x | $5–$9 · P90 $10 | 762 | Benchmark |
| Arkansas | $8.01 | 0.85x | $4–$12 · P90 $23 | 1,094 | Benchmark |
| Pennsylvania | $8.01 | 0.85x | $5–$12 · P90 $23 | 9,787 | Benchmark |
| Illinois | $8.00 | 0.85x | $4–$16 · P90 $22 | 11,350 | Benchmark |
| Michigan | $8.00 | 0.85x | $5–$12 · P90 $23 | 5,141 | Benchmark |
| Missouri | $7.99 | 0.85x | $4–$13 · P90 $24 | 52,094 | Benchmark |
| South Dakota | $7.77 | 0.82x | $5–$12 · P90 $23 | 227 | Benchmark |
| Mississippi | $7.72 | 0.82x | $5–$12 · P90 $23 | 662 | Benchmark |
| Louisiana | $7.63 | 0.81x | $5–$12 · P90 $23 | 1,258 | Benchmark |
| Nebraska | $7.57 | 0.80x | $5–$12 · P90 $23 | 477 | Benchmark |
| Delaware | $7.44 | 0.79x | $5–$12 · P90 $23 | 584 | Benchmark |
| Oklahoma | $7.40 | 0.78x | $5–$12 · P90 $21 | 1,069 | Benchmark |
| Connecticut | $7.27 | 0.77x | $4–$16 · P90 $24 | 3,521 | Benchmark |
| Oregon | $7.17 | 0.76x | $5–$12 · P90 $23 | 1,614 | Benchmark |
| Maryland | $7.15 | 0.76x | $5–$12 · P90 $23 | 3,419 | Benchmark |
| Tennessee | $7.10 | 0.75x | $5–$12 · P90 $20 | 5,828 | Benchmark |
| Hawaii | $6.96 | 0.74x | $6–$12 · P90 $23 | 800 | Benchmark |
| New Jersey | $6.95 | 0.74x | $5–$12 · P90 $22 | 18,157 | Benchmark |
| Alabama | $6.89 | 0.73x | $4–$12 · P90 $17 | 2,145 | Benchmark |
| Arizona | $6.89 | 0.73x | $5–$12 · P90 $23 | 3,110 | Benchmark |
| Washington | $6.87 | 0.73x | $5–$13 · P90 $25 | 2,824 | Benchmark |
| District of Columbia | $6.77 | 0.72x | $5–$12 · P90 $23 | 1,065 | Benchmark |
| Idaho | $6.49 | 0.69x | $6–$12 · P90 $22 | 566 | Benchmark |
| Utah | $6.24 | 0.66x | $5–$12 · P90 $24 | 902 | Benchmark |
| North Dakota | $6.16 | 0.65x | $5–$12 · P90 $23 | 277 | Benchmark |
| Florida | $6.04 | 0.64x | $4–$12 · P90 $23 | 13,876 | Benchmark |
| New York | $5.87 | 0.62x | $4–$18 · P90 $25 | 154,987 | Benchmark |
| New Mexico | $5.85 | 0.62x | $5–$12 · P90 $23 | 894 | Benchmark |
| Montana | $5.83 | 0.62x | $5–$12 · P90 $23 | 437 | Benchmark |
| Nevada | $5.77 | 0.61x | $6–$12 · P90 $23 | 1,366 | Benchmark |
| Virginia | $5.77 | 0.61x | $5–$12 · P90 $23 | 13,616 | Benchmark |
| Iowa | $5.75 | 0.61x | $6–$12 · P90 $23 | 1,179 | Benchmark |
| Minnesota | $5.75 | 0.61x | $6–$20 · P90 $31 | 6,189 | Benchmark |
| Kansas | $5.75 | 0.61x | $4–$11 · P90 $16 | 1,416 | Benchmark |
| Alaska | $5.75 | 0.61x | $5–$12 · P90 $23 | 308 | Benchmark |
| Georgia | $5.75 | 0.61x | $4–$12 · P90 $17 | 83,638 | Benchmark |
| California | $5.75 | 0.61x | $6–$12 · P90 $33 | 129,618 | Benchmark |
| West Virginia | $5.75 | 0.61x | $4–$11 · P90 $23 | 1,333 | Benchmark |
| Massachusetts | $5.05 | 0.54x | $5–$11 · P90 $22 | 6,729 | Benchmark |
| Vermont | $5.05 | 0.54x | $4–$5 · P90 $11 | 948 | Benchmark |
| New Hampshire | $5.05 | 0.54x | $5–$5 · P90 $5 | 6,323 | Benchmark |
| Texas | $5.00 | 0.53x | $4–$8 · P90 $13 | 39,278 | Benchmark |
| Kentucky | $4.86 | 0.52x | $5–$7 · P90 $12 | 18,559 | Benchmark |
| Colorado | $4.66 | 0.49x | $5–$6 · P90 $12 | 8,324 | Benchmark |
| Maine | $4.66 | 0.49x | $4–$5 · P90 $9 | 9,835 | Benchmark |
| Ohio | $4.60 | 0.49x | $4–$8 · P90 $17 | 54,443 | Benchmark |
| Rhode Island | $4.37 | 0.46x | $4–$6 · P90 $13 | 8,433 | Benchmark |
Payer-blind local peer percentiles per state, full verified distribution. Publication floor: 11 verified rate points and a non-degenerate spread; the P25–P75 band unlocks at 25 points, P90 at 100 (a smaller cell's P90 is one contract, not a statistic).
Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.
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Cite this page
Source: Reddenda Code Reality Check, CPT 85025. Reddenda. https://reddenda.health/code/85025/
Derivation federally mandated TiC MRFs, verified to provider identity872,649 verified rate points across 50 statesas of 2026-07-15 · methodology v1.0