CPT code 81007: Bacteria screen, without culture or dipstick2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This focused urine test screens for bacteriuria by a method other than culture or dipstick and is reported when that test is performed.
Medicare pays $29.98 for 81007 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
$29.98
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
- $29.98
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 81007 covers
This service screens a urine specimen for bacteriuria using a method other than culture or dipstick. It is a focused urinalysis, distinct from a broader urinalysis and from culture, which assesses urine by growing organisms. Report this code when the test performed is the bacteriuria screen, rather than simply because bacteria are noted in a broader urine test.
Medicare pays 81007 through the CLFS at one national amount, with no geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $29.98, unchanged since 2020. CMS lists a CLIA-waived version with modifier QW for sites holding a CLIA certificate of waiver. The test is paid only through the CLFS and is excluded from 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 81007
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 81007. 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 81007 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 81007 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $29.98.
81007 on the lab fee schedule since 2020
81007 · CLFS 2026 Q4 (current)
$29.98
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.
81007 compared with similar tests
- 81015Urine microscopyMicroscopy only$3.05
- 81015 reports microscopic examination of urine. Use 81007 for a focused bacteriuria screen performed by a method other than culture or dipstick.
- 81003UrinalysisAutomated, without microscopy$2.25
- 81003 describes a broader automated urinalysis without microscopy. Use 81007 when the service performed is specifically a bacteriuria screen.
- 87086Urine cultureQuantitative colony count$8.07
- 87086 is used when urine culture testing is performed. Code 81007 is for a bacteriuria screen by a method other than culture or dipstick.
81007 billing questions
How does this differ from a urine culture?
81007 reports a bacteriuria screen by a method other than culture. Code 87086 is used when urine culture testing is performed.
Should this be reported with a complete urinalysis?
Choose the code that describes the testing performed. A broader urinalysis code is not interchangeable with this focused bacteriuria screen.
When is modifier QW appropriate?
CMS lists a CLIA-waived version with QW. The modifier identifies the waived version performed by a site holding a CLIA certificate of waiver.
Does Medicare pay this through the physician fee schedule?
No. Medicare pays 81007 through the CLFS at one national amount across localities and settings.
What should the record distinguish?
The record should identify the bacteriuria screen performed, distinguishing it from a urine culture or a broader urinalysis.
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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