CPT code 82523: Collagen crosslinks, urine bone-resorption marker2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures collagen crosslinks in urine as a marker of bone resorption, supporting bone-health evaluation and monitoring of bone turnover.
Medicare pays $18.68 for 82523 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
$18.68
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
- $18.68
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 82523 covers
This urine laboratory test measures collagen crosslinks, products associated with breakdown of bone collagen, and is used to evaluate bone health. Clinicians may order it when assessing bone turnover or following response to osteoporosis therapy. Clinical laboratories perform and report the assay for outpatient providers managing bone health; the code covers testing by any method.
Report the urine collagen-crosslink assay performed. CMS recognizes a CLIA-waived version reported with modifier QW by a site holding a CLIA certificate of waiver. Medicare pays the test through the CLFS at one national amount across localities, without an office-versus-facility difference. The 2026 national CLFS amount is $18.68, unchanged from 2020 through 2025. The test is paid only through 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 82523
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 82523. 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 82523 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 82523 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $18.68.
82523 on the lab fee schedule since 2020
82523 · CLFS 2026 Q4 (current)
$18.68
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.
82523 compared with similar tests
- 82570Urine creatinineUrine specimen$5.18
- Code 82570 measures urine creatinine, not collagen breakdown products. It may be reported for a separately performed creatinine measurement used in creatinine-normalized reporting.
- 82565CreatinineBlood specimen$5.12
- Code 82565 is a creatinine assay; it does not measure urinary collagen crosslinks or bone resorption.
82523 billing questions
When should I report modifier QW?
Use QW for the CLIA-waived version when the testing site holds a CLIA certificate of waiver.
How does Medicare pay for this test?
Medicare pays it through the CLFS at one national amount, without locality or office-versus-facility variation.
How is this different from code 82570?
Code 82523 measures urine collagen crosslinks; 82570 measures urine creatinine, which may be separately measured for creatinine-normalized reporting.
Can code 82565 be used instead?
No. Code 82565 is a creatinine assay, not a test for urinary collagen crosslinks.
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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