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See a sample rate comparisonCPT 81003 Fee Schedule
Medicare rates as of January 2026
CPT 81003 is classified under Pathology and Laboratory Procedures, in the Urinalysis Procedures subgroup.
Urine Analysis, Urine Test That Checks Ph And Looks For Substances Such As Blood Crystals Bile And White Blood Cells (Antibodies). These May Be Viewed Under A Microscope Or Detected With Dip Sticks Or Colorizing Tablets. A Computer Analysis May Be Done As Well.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Urinalysis Procedures |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | QW - CLIA Waived Tests 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $2.25 national lab fee schedule rate (2026) · View Medicare rates for 81003 |
| Medicaid Fee Schedule | $2.07 median of the 8 states in the free preview · View Medicaid rates for 81003 |
National average reimbursement for CPT 81003 by major payers:
$2.22
BCBS / Anthem
$2.91
UnitedHealthcare
$3.02
Aetna
$3.36
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 81003.
CPT 81003
5 of 25 sample ratesHigher to lower in this preview
Chimalum Okafor
$8.27Published rateMark Vlasak
$3.05Published rateAdhi Jayaraman
Afc Physicians Of Tennessee PC
$2.59Published rateBryan Merrick
Mckenzie Medical Center, P.C.
$2.16Published rateBaptist Memorial Medical Group Inc
$1.35Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 81003 vs. Other Urinalysis Procedures Codes
The table lists codes related to 81003. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 81000-CPT | Low | Urine Analysis, Urine Test That Checks Ph And Looks For Substances Such As Blood Crystals Bile And White Blood Cells (Antibodies). These May Be Viewed Under A Microscope Or Detected With Dip Sticks Or Colorizing Tablets. A Computer Analysis May Be Done As Well. |
| 81001-CPT | Low | Urine Analysis, Urine Test That Checks Ph And Looks For Substances Such As Blood Crystals Bile And White Blood Cells (Antibodies). These May Be Viewed Under A Microscope Or Detected With Dip Sticks Or Colorizing Tablets. A Computer Analysis May Be Done As Well. |
| 81002-CPT | Low | Urine Analysis, Urine Test That Checks Ph And Looks For Substances Such As Blood Crystals Bile And White Blood Cells (Antibodies). These May Be Viewed Under A Microscope Or Detected With Dip Sticks Or Colorizing Tablets. A Computer Analysis May Be Done As Well. |
| 81003-CPT | Low | Urine Analysis, Urine Test That Checks Ph And Looks For Substances Such As Blood Crystals Bile And White Blood Cells (Antibodies). These May Be Viewed Under A Microscope Or Detected With Dip Sticks Or Colorizing Tablets. A Computer Analysis May Be Done As Well. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81003. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81003 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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Frequently Asked Questions
CPT stands for Current Procedural Terminology. CPT codes are standardized five-character alphanumeric codes used by healthcare professionals to describe medical, surgical, and diagnostic services to payers for reimbursement. They are essential for accurate medical billing and record-keeping, ensuring a common language for services rendered.
Finding the exact cost of a medical procedure can be complex due to varying prices across providers, insurance plans, and geographic locations. To get an estimate, you can contact your healthcare provider directly, speak with your insurance company to understand your coverage and potential out-of-pocket costs, or use price transparency tools. For specific fee schedule information based on CPT codes and your location, Payerprice offers a specialized lookup tool that can assist you in searching for this data.
CPT codes identify the specific medical services performed, but they do not directly dictate the cost. Procedure costs are the actual monetary charges for those services, which can vary widely based on the healthcare provider, geographic location, insurance negotiation, and the patient's specific insurance plan. In essence, a CPT code describes 'what' was done, while the procedure cost describes 'how much' it costs.
For users looking to find fee schedules and pricing information for specific CPT codes in a particular location, Payerprice offers a specialized fee schedule lookup tool. This tool allows users to search with CPT codes and specific locations to get relevant pricing data. This can be particularly useful for comparing costs and understanding potential expenses before receiving care.
Healthcare pricing transparency is a complex issue due to several factors. Prices for the same service can vary significantly between different hospitals, clinics, and even within the same facility because of negotiated rates with various insurance companies, differing overhead costs, and proprietary pricing strategies. This lack of standardization makes it challenging for consumers to find clear and consistent pricing information upfront. Tools like Payerprice aim to improve transparency by providing accessible fee schedule data.