CPT 81015 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 • TC - Technical component |
| Complexity Level | Low |
National average reimbursement for CPT 81015 by major payers:
$3.05
$2.83
$3.92
$4.44
| 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 81015 | ||||||
United | 81015 | $2.60 | 1760429831 - BRUCE MADSEN | 260210091 - (OR) BRIDGEPORT EYE PHYSICIANS LLC | OR | Ophthalmology Physician (207W00000X) |
United | 81015 | $2.50 | 1760429831 - BRUCE MADSEN | 930590581 - EYECARE ASSOCIATES PC | OR | Ophthalmology Physician (207W00000X) |
United | 81015 | $2.75 | 1417505694 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH HILLCREST HOSPITAL VASCULAR LAB | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 81015 | $3.55 | 1922119221 - KURT KAUFFMAN | 481187229 - (KS) ASSOCIATES IN WOMENS HEALTH PA | KS | Obstetrics & Gynecology Physician (207V00000X) |
United | 81015 | $3.04 | 1285094102 - PELVIC HEALTH SPECIALISTS, LLC | 811514129 - (KS) PELVIC HEALTH SPECIALISTS LLC | KS | Female Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician (207VF0040X) |
United | 81015 | $6.44 | 1629575519 - CLARE HINCHEY | 431598353 - SAINT LUKES PHYSICIAN GROUP INC | KS | Obstetrics & Gynecology Physician (207V00000X) |
United | 81015 | $3.04 | 1265926612 - ALEX FINLINSON | 923074164 - (KS) KC FULL CIRCLE MIDWIFERY FAMILY | KS | Obstetrics & Gynecology Physician (207V00000X) |
United | 81015 | $3.04 | 1952306771 - MICHAEL MAGEE | 872020101 - (KS) ASSURE OB LLC | KS | Obstetrics & Gynecology Physician (207V00000X) |
United | 81015 | $3.04 | 1790718708 - SHEREBANU GASLIGHTWALA | 753164164 | KS | Obstetrics & Gynecology Physician (207V00000X) |
United | 81015 | $6.44 | 1689646499 - CHRISTINE SANDERS | 431598353 - SAINT LUKES PHYSICIAN GROUP INC | KS | Obstetrics & Gynecology Physician (207V00000X) |
United | 81015 | $3.04 | 1952306771 - MICHAEL MAGEE | 753164164 | KS | Obstetrics & Gynecology Physician (207V00000X) |
United | 81015 | $6.21 | 1205859030 - JANEY MAKI | 480993446 - (KS) VIA CHRISTI CLINIC, P.A. | KS | Obstetrics & Gynecology Physician (207V00000X) |
United | 81015 | $3.04 | 1417121492 - DOUGLAS MOORE | 480917047 | KS | Obstetrics & Gynecology Physician (207V00000X) |
United | 81015 | $3.04 | 1457471138 - ERIN CAREY | 561732213 | KS | Obstetrics & Gynecology Physician (207V00000X) |
United | 81015 | $1.83 | 1295737633 - CHARLES BUTRICK | 462298769 - (KS) UROGYNECOLOGY RECONSTRUCTIVE PELVIC SURGERY OF KANSAS CITY LLC | KS | Female Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician (207VF0040X) |
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 81015 vs. Other Urinalysis Procedures Codes
The CPT 81015 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 81015 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 |
|---|---|---|
| 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 |
| 81003-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, Without Microscopy |
| 81005-CPT | Low | Urinalysis; Qualitative Or Semiquantitative, Except Immunoassays |
| 81015-CPT | Low | Urinalysis Microscopic Onlyur |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81015. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81015 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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