CPT code 82010: Ketone bodies, quantitative2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Quantitative ketone body analysis reports a measured ketone level and is used when clinicians evaluate or monitor significant ketosis, including diabetic ketoacidosis.
Medicare pays $8.17 for 82010 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
$8.17
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
- QW · CLIA-waived test
- $8.17
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 82010 covers
Code 82010 identifies laboratory analysis that measures ketone bodies quantitatively. Clinicians use measured ketone results when evaluating or monitoring significant ketosis, including diabetic ketoacidosis. Hospital and outpatient laboratories perform or report the assay as part of a patient's laboratory workup. Select this code when the service measures ketone bodies quantitatively, rather than reporting them qualitatively.
Report 82010 for the quantitative assay; use 82009 when the performed test is qualitative. Modifier QW identifies the CLIA-waived version for sites holding a CLIA certificate of waiver. Medicare pays 82010 only through the CLFS, at one national amount across localities with no office or facility difference. The 2026 national CLFS amount is $8.17, unchanged since 2020.
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 82010
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 82010. 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 82010 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 82010 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $8.17.
82010 on the lab fee schedule since 2020
82010 · CLFS 2026 Q4 (current)
$8.17
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.
82010 compared with similar tests
- 82009Ketone testQualitative result$4.52
- 82009 reports qualitative ketone analysis; 82010 is for a quantitative measurement.
- 81003UrinalysisAutomated, without microscopy$2.25
- 81003 is automated urinalysis without microscopy and may include a urine ketone finding. 82010 identifies quantitative ketone body analysis.
82010 billing questions
When should 82010 be used instead of 82009?
Use 82010 when the laboratory measures ketone bodies quantitatively. Use 82009 when the performed test reports ketones qualitatively.
When is modifier QW appropriate?
QW identifies the CLIA-waived version of the test and is used for that version at sites holding a CLIA certificate of waiver.
Does 82010 include a glucose test?
No. 82010 identifies quantitative ketone body analysis; glucose measurement is a distinct laboratory test.
How does Medicare pay for 82010?
Medicare pays 82010 through the CLFS at one national amount that applies across localities, with no office or facility difference.
Is there a separate physician-fee-schedule payment for 82010?
No. Medicare pays this test only through the CLFS.
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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