CPT code 84578: Urine urobilinogen, qualitative measurement2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Qualitative urine urobilinogen testing reports a finding rather than a concentration and may support evaluation of liver disorders or increased red-cell breakdown.
Medicare pays $4.47 for 84578 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
$4.47
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 84578 covers
This assay determines urobilinogen qualitatively in a urine specimen. Urobilinogen forms during bilirubin metabolism, and urine testing may be used when evaluating liver disorders or increased red-cell breakdown. The result is qualitative rather than a measured concentration. Clinical laboratories perform and report the assay; it may be ordered as part of urine testing.
Report 84578 for qualitative urine urobilinogen analysis, not for fecal testing or a quantitative urine assay. When urobilinogen is already included in a reported urinalysis, do not separately report the same component. Medicare pays this laboratory test only under the CLFS. The 2026 national amount is $4.47, the same in every state and locality, with no geographic or office/facility adjustment. The amount has remained 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 84578
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 84578. 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 84578 with status X (excluded by statute), so the test itself is paid only from the CLFS.
84578 on the lab fee schedule since 2020
84578 · CLFS 2026 Q4 (current)
$4.47
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.
84578 compared with similar tests
- 84580Urine urobilinogenTimed urine collection$9.55
- Use 84578 for qualitative urine testing and 84580 for quantitative urine testing.
- 84583Urine urobilinogenSemiquantitative assay$6.05
- Use 84583 for quantitative testing of a timed urine specimen; 84578 is qualitative.
- 84577Stool urobilinogenQuantitative stool specimen$16.80
- Code 84578 is for urine; 84577 is for urobilinogen testing of feces.
84578 billing questions
How do I choose among 84578, 84580, and 84583?
Use 84578 for qualitative urine testing, 84580 for quantitative urine testing, and 84583 for quantitative testing of a timed urine specimen.
Can 84578 be used for a stool specimen?
No. Code 84578 is for urine; 84577 is for fecal urobilinogen testing.
Can 84578 be reported with a urinalysis?
Do not separately report the urobilinogen component when it is included in a reported urinalysis. Report 84578 when a distinct qualitative urine assay is performed and separately reportable.
Does Medicare pay 84578 through the physician fee schedule?
No. Medicare pays this test only through the CLFS.
What should the documentation show?
Document the urine specimen and the qualitative urobilinogen assay performed, distinguishing it from quantitative or fecal testing.
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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