CPT code 81003: Urinalysis, automated, without microscopy2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Automated urinalysis measures urine chemical indicators without microscopy and is reported when clinicians evaluate urinary symptoms or monitor conditions such as diabetes or kidney disease.
Medicare pays $2.25 for 81003 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
$2.25
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
- QW · CLIA-waived test
- $2.25
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 81003 covers
Code 81003 describes an automated reagent-based urinalysis without microscopic examination. The analyzer reads chemical indicators in urine, which may include hemoglobin, bilirubin, glucose, ketones, leukocytes, nitrite, pH, protein, specific gravity, and urobilinogen. Clinicians commonly order it when evaluating urinary symptoms or monitoring conditions such as diabetes or kidney disease. Physician-office staff and clinical laboratories perform the test in office and outpatient settings.
Report one service for the automated nonmicroscopic test, rather than separate units for each measured constituent. Append QW for the CLIA-waived version when a site holding a CLIA certificate of waiver performs the test. Medicare pays the test only under the CLFS. The 2026 national CLFS amount is $2.25, unchanged since 2020; the same amount applies across states and localities, without geographic or office/facility adjustment. The test is paid only under the CLFS, not 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 81003
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 81003. 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 81003 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 81003 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $2.25.
81003 on the lab fee schedule since 2020
81003 · CLFS 2026 Q4 (current)
$2.25
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.
81003 compared with similar tests
- 81001UrinalysisAutomated with microscopy$3.17
- Both use an automated method; 81001 includes microscopic examination, while 81003 does not.
- 81002UrinalysisManual, no microscopy$3.48
- Both are urinalysis services without microscopy, but 81002 is nonautomated and 81003 is automated.
- 81000UrinalysisManual, with microscopy$4.02
- 81000 is nonautomated and includes microscopy; 81003 is automated and does not include microscopy.
81003 billing questions
How does 81003 differ from 81001?
Both describe automated urinalysis, but 81003 is performed without microscopy. Use 81001 when the service includes microscopic examination.
How does 81003 differ from 81002?
Both are nonmicroscopic urinalysis services. Code 81003 is automated; 81002 is nonautomated.
When should modifier QW be reported?
Append QW for the CLIA-waived version when the test is performed by a site holding a CLIA certificate of waiver.
Are units reported for each urine constituent?
No. Report one service for the automated urinalysis, not separate units for the individual chemical indicators measured.
How does Medicare pay for 81003?
Medicare pays it only under the CLFS, at one national amount across states and localities. The payment does not vary by office or facility setting.
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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