CPT code 81001: Urinalysis, automated with microscopy2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports an automated urine reagent test with microscopic examination when both chemical screening and urine sediment review are performed.
Medicare pays $3.17 for 81001 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
$3.17
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 81001 covers
This service combines automated reagent testing of urine with examination by microscope. The reagent portion assesses urine constituents such as glucose, blood, protein, and leukocytes; microscopy evaluates the urine sediment. It is commonly performed by laboratory staff or in a clinician’s office when evaluating urinary symptoms, suspected infection, or other conditions that may affect the urine.
Report one service for each urinalysis performed with both automated testing and microscopy. The code includes the microscopic examination, so do not separately report a microscopy-only service for that same examination. Medicare pays the test only through the CLFS. The 2026 national CLFS amount is $3.17, unchanged since 2020; the same amount applies across localities and in office and facility settings. There is no separate physician interpretation payment under the physician fee schedule.
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 81001
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 81001. 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 81001 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81001 on the lab fee schedule since 2020
81001 · CLFS 2026 Q4 (current)
$3.17
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.
81001 compared with similar tests
- 81000UrinalysisManual, with microscopy$4.02
- Choose 81000 when urinalysis is performed manually and includes microscopy; choose 81001 when the testing is automated and microscopy is included.
- 81002UrinalysisManual, no microscopy$3.48
- 81002 describes manual urinalysis without microscopy. 81001 describes automated testing with microscopy.
- 81003UrinalysisAutomated, without microscopy$2.25
- Both describe automated urinalysis, but 81001 includes microscopy and 81003 does not.
- 81015Urine microscopyMicroscopy only$3.05
- 81015 describes a microscopic examination of urine. Use 81001 when automated urinalysis and microscopy are both performed as one service.
81001 billing questions
When should 81001 be selected instead of 81003?
Use 81001 when automated reagent testing and microscopic examination are both performed. Use 81003 when automated testing is performed without microscopy.
Is the microscopic examination separately billable?
No. The microscopic examination is included in 81001 when performed as part of this urinalysis.
How many units are reported?
Report one service for each urinalysis performed with automated testing and microscopy. Document that both parts of the test were completed.
Can 81001 be reported with 81000 or 81002 for the same urinalysis?
Do not report a second urinalysis code for the same test. Those codes describe manual testing, while 81001 describes automated testing with microscopy.
How does Medicare pay for 81001?
Medicare pays 81001 through the CLFS. Payment is one national amount across localities and office and facility settings, with no separate physician interpretation payment under the physician fee schedule.
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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