CPT 81001 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Pathology and Laboratory Procedures • Urinalysis Procedures |
| Common Place of Service | • 81 - Independent Laboratory • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • 59 - Distinct Procedural Service |
| Complexity Level | Low |
National average reimbursement for CPT 81001 by major payers:

$3.13

$3.00

$4.22

$4.89
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 81001 | ||||||
United | 81001 | $2.84 | 1174595466 - KAMRAN TASHAROFI | 251918025 - (NJ) UNION COUNTY HEALTHCARE ASSOCIATES, LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $2.84 | 1912232695 - SREEVANI THOTA | 853737205 | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $1.59 | 1962548727 - FIDEL LIM | 223412735 | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $1.59 | 1578511135 - JAMES AGRESTI | 474590093 - (NJ) JAMES V AGRESTI DO LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $3.00 | 1740656024 - ALLISON MULLARNEY | 811200310 - CAPITAL HEALTH MULTISPECIALTY GROUP | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $2.95 | 1114320942 - LLOYD WEBSTER | 811200310 - CAPITAL HEALTH MULTISPECIALTY GROUP | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $1.89 | 1528027356 - MOHAMED KASSEM | 593140335 - BAYCARE MEDICAL GROUP INC | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $1.89 | 1194285981 - DHRUV PATEL | 901116751 - BANNER | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $9.82 | 1740656024 - ALLISON MULLARNEY | 410991680 - FAIRVIEW HEALTH SERVICES | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $2.38 | 1548378029 - HILAL ABBOUSHI | 134215150 - (NJ) HILAL MEDICAL CENTER LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $2.84 | 1477583235 - SUMALATHA MANNAVA | 853737205 | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $2.00 | 1669422762 - MARYGRACE ZETKULIC | 223376459 - HACKENSACK MERIDIAN HEALTH MEDICAL GROUP-SPECIALTY CARE PC | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $3.84 | 1659784247 - MARY NAKHLA | 223376459 - HACKENSACK MERIDIAN HEALTH MEDICAL GROUP-SPECIALTY CARE PC | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $2.00 | 1962923714 - MOHAMED ELGENDY | 223376459 - HACKENSACK MERIDIAN HEALTH MEDICAL GROUP-SPECIALTY CARE PC | NJ | Internal Medicine Physician (207R00000X) |
United | 81001 | $1.59 | 1487853875 - NAGWA HAFEZ | 271617859 - (NJ) ADVANCED GERIATRICS INC | NJ | Internal Medicine Physician (207R00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 81001 vs. Other Urinalysis Procedures Codes
The CPT 81001 code is part of the Pathology and Laboratory Procedures services used for Urinalysis Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 81001 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 80416-CPT | Low | Renal Vein Renin Stimulation Panel |
| 81000-CPT | Low | Urinalysis, By Dip Stick Or Tablet Reagent For Bilirubin, Glucose, Hemoglobin, Ketones, Leukocytes, Nitrite, Ph, Protein, Specific Gravity, Urobilinogen, Any Number Of These Constituents; Non-Automated, With Microscopy |
| 81001-CPT | Low | Urinalysis, By Dip Stick Or Tablet Reagent For Bilirubin, Glucose, Hemoglobin, Ketones, Leukocytes, Nitrite, Ph, Protein, Specific Gravity, Urobilinogen, Any Number Of These Constituents; Automated, With Microscopy |
| 81002-CPT | Low | Urinalysis, By Dip Stick Or Tablet Reagent For Bilirubin, Glucose, Hemoglobin, Ketones, Leukocytes, Nitrite, Ph, Protein, Specific Gravity, Urobilinogen, Any Number Of These Constituents; Non-Automated, Without Microscopy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81001. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81001 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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