CPT code 82009: Ketone test, qualitative result2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Qualitative ketone body analysis reports a finding rather than a concentration when a clinician requests qualitative testing for ketone bodies.
Medicare pays $4.52 for 82009 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
$4.52
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 82009 covers
82009 identifies qualitative analysis of ketone bodies. The analytes can include acetone, acetoacetic acid, and beta-hydroxybutyrate. The result is qualitative rather than a measured concentration, distinguishing this test from quantitative ketone body analysis. A laboratory performs and reports the assay when a clinician requests a qualitative ketone body result.
For billing, select 82009 for qualitative ketone body analysis and 82010 for quantitative analysis. Medicare pays 82009 under the CLFS at one national amount that applies in every state and locality, with no office or facility difference. The 2026 national CLFS amount is $4.52, unchanged from 2020 through 2026. Medicare pays the test only through the CLFS; it 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 82009
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 82009. 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 82009 with status X (excluded by statute), so the test itself is paid only from the CLFS.
82009 on the lab fee schedule since 2020
82009 · CLFS 2026 Q4 (current)
$4.52
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.
82009 compared with similar tests
- 82010Ketone bodiesQuantitative$8.17
- Choose 82009 for qualitative analysis and 82010 for quantitative analysis of ketone bodies.
- 81002UrinalysisManual, no microscopy$3.48
- 81002 describes nonautomated urinalysis; 82009 describes qualitative ketone body analysis.
- 81003UrinalysisAutomated, without microscopy$2.25
- 81003 describes automated urinalysis; 82009 describes qualitative ketone body analysis.
82009 billing questions
When should 82009 be used instead of 82010?
Use 82009 for qualitative ketone body analysis. Use 82010 when the analysis is quantitative.
Does 82009 report a concentration?
No. It reports a qualitative finding; quantitative ketone body analysis is reported with 82010.
Which ketone bodies can be included in the analysis?
The analysis can include acetone, acetoacetic acid, and beta-hydroxybutyrate.
How does 82009 differ from 81002 or 81003?
Codes 81002 and 81003 describe nonautomated and automated urinalysis, respectively. Code 82009 describes qualitative ketone body analysis.
How does Medicare pay 82009?
Medicare pays it through the CLFS at one national amount, with the same payment across localities and no office or facility difference.
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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