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See a sample rate comparisonCPT 81005 Fee Schedule
Medicare rates as of January 2026
CPT 81005 is classified under Pathology and Laboratory Procedures, in the Urinalysis Procedures subgroup.
Urine Analysis For A Substance, Basic Urine Analysis For A Particular Substance Such As Blood Antibodies Bile Or Crystals. The Result May Be Recorded Simply As Positive Or Negative.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Urinalysis Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | EP - Residential facility to Physician's office QW - CLIA Waived Tests |
| Complexity Level | Low |
| Medicare Fee Schedule | $2.17 national lab fee schedule rate (2026) · View Medicare rates for 81005 |
| Medicaid Fee Schedule | $2.00 median of the 8 states in the free preview · View Medicaid rates for 81005 |
National average reimbursement for CPT 81005 by major payers:
$1.99
BCBS / Anthem
$2.06
UnitedHealthcare
$2.61
Aetna
$3.24
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 81005.
CPT 81005
5 of 25 sample ratesHigher to lower in this preview
Scott & White Memorial Hospital, Baylor Scott & White Medical Center - Temple
Scott & White Clinic
$4.17Published rateEssent Prmc Lp, Paris Regional Medical Center
$2.17Published rateUnion Medical Center, Union Medical Center
$2.17Published rateThe Good Shepherd Hospital, Inc., Christus Good Shepherd Medical Center - Longview
Good Shepherd Hospital Inc
$1.84Published ratePark Place Surgery Center, LLC, Park Place Surgical Hospital
Park Place Surgical Hospital
$0.77Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 81005 vs. Other Urinalysis Procedures Codes
The table lists codes related to 81005. 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. |
| 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. |
| 81005-CPT | Low | Urine Analysis For A Substance, Basic Urine Analysis For A Particular Substance Such As Blood Antibodies Bile Or Crystals. The Result May Be Recorded Simply As Positive Or Negative. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81005. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81005 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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