CPT code 81000: Urinalysis, manual, with microscopy2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports a manually performed urine reagent test with microscopic examination, commonly used to assess urinary findings in office and laboratory settings.
Medicare pays $4.02 for 81000 under the 2026 Clinical Laboratory Fee Schedule: one national amount, the same in every state and setting.
Medicare lab fee · CLFS 2026 Q4
National CLFS amount
$4.02
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2020
- Unchanged
- CMS updates
- Quarterly
Medicare pays the lesser of the lab’s charge and this amount. Patients usually owe no Part B deductible or coinsurance for covered clinical lab tests.
On this page 8 sections
What 81000 covers
This service combines a manual urine dipstick or tablet-reagent test with microscopic examination of the urine. The reagent portion may assess one or more constituents, such as blood, protein, glucose, leukocytes, or nitrite; microscopy adds examination of formed elements. Primary care practices, urology offices, and clinical laboratories commonly perform or report the test when evaluating urinary symptoms or abnormal screening findings.
Report one unit for the manual urinalysis performed, not separate units for each reagent constituent. Microscopy is part of this code’s service; it is not the automated method or a reagent test without microscopy. Medicare pays the test only through the CLFS. The 2026 national CLFS amount is $4.02, the same amount listed for each year from 2020 through 2026. The amount applies in every state and locality, without geographic or office/facility adjustment.
This summary was written with AI assistance from CMS Clinical Laboratory Fee Schedule data. Amounts on this page come directly from CMS files.
How Medicare pays 81000
Clinical lab tests aren’t priced like physician services. They’re paid from their own fee schedule, with its own rules. See the whole lab fee schedule.
One national amount
CMS sets a single Clinical Laboratory Fee Schedule amount for 81000. There’s no geographic (GPCI) adjustment, so it pays the same in every state and payment locality.
No office or facility rate
Lab tests aren’t built from relative value units, so there’s no office and facility split: the place of service doesn’t change the CLFS amount.
Updated every quarter
CMS republishes the CLFS each quarter. New tests, often proprietary laboratory analyses (PLA codes), join during the year; existing amounts are updated each January.
Excluded from the physician fee schedule
The physician fee schedule lists 81000 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81000 on the lab fee schedule since 2020
81000 · CLFS 2026 Q4 (current)
$4.02
Unchanged since Jan 1, 2020
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
81000 compared with similar tests
- 81001UrinalysisAutomated with microscopy$3.17
- Both include microscopy; 81000 is for manual reagent testing, while 81001 is for automated testing.
- 81002UrinalysisManual, no microscopy$3.48
- Both are manual reagent urinalyses. Choose 81000 when microscopy is performed and 81002 when it is not.
- 81003UrinalysisAutomated, without microscopy$2.25
- 81003 describes automated reagent testing without microscopy. 81000 describes manual testing that includes microscopy.
- 81015Urine microscopyMicroscopy only$3.05
- 81015 is for microscopic examination of urine alone; 81000 includes microscopy with a manual reagent urinalysis.
81000 billing questions
When should 81000 be chosen over 81001?
Use 81000 when the reagent testing is performed manually and microscopy is included. Use 81001 when the urinalysis is automated and includes microscopy.
Is microscopy included in 81000?
Yes. The service includes microscopic examination, so do not report a separate microscopy service for that same examination.
Is the code reported per reagent constituent?
No. Report one unit for the manual urinalysis, regardless of how many reagent constituents are tested.
How does 81000 differ from 81002?
Both describe manual reagent testing. Use 81000 when microscopy is performed and 81002 when it is not.
How does Medicare pay 81000?
Medicare pays it through the CLFS at one national amount for all states and localities, with no office or facility adjustment.
Where this amount comes from
FeeBase reads lab amounts directly from the CMS Clinical Laboratory Fee Schedule file for the quarter: one row per code, with its payment indicator and national amount. Contractor-priced tests are labeled, never given a made-up amount. Amounts are Medicare payment limits, not a patient’s bill or a commercial rate.
CMS CLFS 2026 Q4 · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file line behind this amount
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