CPT code 82565: Creatinine, blood specimen2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A blood creatinine assay measures circulating creatinine to assess kidney function, monitor renal status, or support medication dosing decisions.
Medicare pays $5.12 for 82565 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
$5.12
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
- $5.12
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 82565 covers
This laboratory assay measures creatinine in blood. Clinicians commonly order it when evaluating or monitoring kidney function, including for patients with suspected or established kidney disease, and when assessing renal status for medication management. It may be ordered alone or as part of a broader chemistry panel. Results can also contribute to estimated glomerular filtration rate calculations; the assay itself reports a blood creatinine result.
Report one assay for the blood test performed. For the CLIA-waived version, use modifier QW when performed by a site holding a CLIA certificate of waiver. Medicare pays the test only through the CLFS. The 2026 national CLFS amount is $5.12, unchanged since 2020; the amount is the same across localities, with no office or facility difference. The physician fee schedule excludes this test.
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 82565
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 82565. 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 82565 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 82565 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $5.12.
82565 on the lab fee schedule since 2020
82565 · CLFS 2026 Q4 (current)
$5.12
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.
82565 compared with similar tests
- 82570Urine creatinineUrine specimen$5.18
- Use 82565 for blood and 82570 for urine. The specimen tested determines the applicable assay code.
- 82575Creatinine clearanceTimed urine and serum$9.46
- 82565 reports blood creatinine concentration; 82575 reports a creatinine clearance test.
- 80048Basic metabolic panelTotal calcium$8.46
- Use 80048 when the basic metabolic panel is performed; it includes creatinine along with other chemistry tests. Use 82565 for a standalone blood creatinine assay.
- 80053Metabolic panelFourteen blood chemistry tests$10.56
- Use 80053 when the comprehensive metabolic panel is performed; it includes creatinine among its broader set of tests. Use 82565 for a standalone blood creatinine assay.
82565 billing questions
When should 82565 be reported instead of 82570?
Use 82565 for a blood creatinine assay and 82570 for a urine creatinine assay. Select the code that matches the specimen tested.
How does 82565 differ from a creatinine clearance test?
82565 reports blood creatinine concentration. Code 82575 is used for a creatinine clearance test, which is a different laboratory service.
When is modifier QW appropriate?
Append QW for the CLIA-waived version when the test is performed by a site holding a CLIA certificate of waiver.
Can 82565 be reported separately with a chemistry panel?
Basic and comprehensive metabolic panels include creatinine among their tests. When the blood creatinine assay is part of a reported panel, do not separately report the same assay as an additional test.
How does Medicare pay 82565?
Medicare pays 82565 through the CLFS at one national amount, with no locality or office-versus-facility difference. The physician fee schedule excludes the test.
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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