CPT code 82355: Stone analysis, qualitative analysis2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Qualitative calculus analysis characterizes submitted urinary stone material, commonly after a stone passes or is removed during treatment.
Medicare pays $11.58 for 82355 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
$11.58
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 82355 covers
Laboratory staff analyze submitted calculus material to characterize its composition qualitatively. The test is commonly ordered after a urinary stone passes or is removed, helping clinicians such as urologists and nephrologists evaluate stone disease. The specimen is the stone material itself, not blood or urine tested for a stone-related substance. The laboratory reports the qualitative result to the clinician evaluating stone disease.
Report 82355 when the service is qualitative calculus analysis. It is distinct from quantitative analysis and from calculus testing identified by a specific analytical technique. Medicare pays the test only through the CLFS. The 2026 national CLFS amount is $11.58, unchanged since 2020; one national amount applies across localities, with no office or facility payment difference.
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 82355
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 82355. 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 82355 with status X (excluded by statute), so the test itself is paid only from the CLFS.
82355 on the lab fee schedule since 2020
82355 · CLFS 2026 Q4 (current)
$11.58
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.
82355 compared with similar tests
- 82360Stone analysisQuantitative chemical analysis$12.87
- Choose 82355 for qualitative analysis; 82360 is for quantitative calculus analysis.
- 82365Stone analysisInfrared method$12.90
- 82365 identifies calculus analysis using spectroscopy. Report 82355 when the service is qualitative analysis rather than that method-specific test.
- 82370Stone analysisX-ray diffraction$12.52
- 82370 identifies X-ray-based calculus analysis. Use 82355 for qualitative analysis when the service is not identified by that technique.
82355 billing questions
What specimen is analyzed?
The service analyzes submitted calculus material, typically a urinary stone that has passed or been removed.
When should 82355 be chosen over 82360?
Use 82355 for qualitative analysis. Code 82360 represents quantitative calculus analysis.
How does 82355 differ from 82365 and 82370?
Those sibling codes identify calculus analysis by spectroscopy and X-ray-based testing, respectively. Choose the code that reflects the analysis performed.
What documentation supports reporting 82355?
The laboratory record should identify the submitted calculus and show that qualitative analysis was performed.
How does Medicare pay for 82355?
Medicare pays it only under the CLFS at one national amount that applies across localities and care settings.
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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