CPT code 84525: Urea nitrogen, semiquantitative2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A semiquantitative urea nitrogen test assesses this kidney-function marker and is reported when the performed test provides a semiquantitative result.
Medicare pays $5.13 for 84525 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
$5.13
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 84525 covers
84525 represents a semiquantitative assessment of urea nitrogen, a laboratory measure used to assess kidney function. The method may use a reagent strip; unlike a quantitative assay, it does not report a precise concentration. Report it when the semiquantitative test is performed, rather than assigning it solely based on the clinical question. Code 84520 is the quantitative urea nitrogen assay, while 84540 is a urine urea nitrogen assay and 84545 evaluates urea nitrogen clearance.
Medicare pays 84525 through the CLFS, with one national amount across states and localities and no office-versus-facility difference. The 2026 national CLFS amount is $5.13, unchanged from 2020 through 2026. The test is excluded from the physician fee schedule and paid only through the CLFS.
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 84525
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 84525. 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 84525 with status X (excluded by statute), so the test itself is paid only from the CLFS.
84525 on the lab fee schedule since 2020
84525 · CLFS 2026 Q4 (current)
$5.13
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.
84525 compared with similar tests
- 84520Blood urea nitrogenQuantitative assay$3.95
- 84525 reports a semiquantitative result; 84520 is the quantitative urea nitrogen assay.
- 84540Urine urea nitrogenUrine specimen$5.56
- 84540 is for a urine urea nitrogen assay. Choose 84525 when the test performed is semiquantitative urea nitrogen testing.
- 84545Urea clearanceClearance calculation$7.20
- 84545 is a urea nitrogen clearance test, not a semiquantitative urea nitrogen level.
84525 billing questions
When should 84525 be reported instead of 84520?
Report 84525 for a semiquantitative urea nitrogen result. Use 84520 when the test performed is a quantitative urea nitrogen assay.
What method does 84525 represent?
It represents semiquantitative urea nitrogen testing, which may use a reagent-strip method.
Which code applies to a urine urea nitrogen assay?
Use 84540 for a urine urea nitrogen assay. Code 84525 represents semiquantitative testing.
Is modifier 26 reported with 84525?
No. Medicare pays 84525 only through the CLFS; the code is excluded from the physician fee schedule.
How does Medicare pay 84525?
Medicare pays one national CLFS amount across localities, with no office-versus-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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