CPT 81050 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 • 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81050 |
National average reimbursement for CPT 81050 by major payers:
$3.37
$2.38
$3.94
$5.49
| 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 81050 | ||||||
United | 81050 | $4.94 | 1598750721 - HUNT MEMORIAL HOSPITAL DISTRICT, HUNT REGIONAL | 751277293 - (TX) HUNT MEMORIAL HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 81050 | $3.79 | 1669480323 - KELL WEST REGIONAL HOSPITAL LLC | 752756307 - KELL WEST REGIONAL HOSPITAL, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 81050 | $8.01 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 81050 | $3.64 | 1811942238 - KPH-CONSOLIDATION, INC., HCA HOUSTON HEALTHCARE NORTH CYPRESS A CAMPUS OF HCA HOUSTON HEALTHCAR | 621619857 | TX | General Acute Care Hospital (282N00000X) |
United | 81050 | $4.12 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 81050 | $1.97 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 81050 | $8.01 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 81050 | $2.91 | 1851768337 - KELLY RIDGES | 362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C. | IL | Family Nurse Practitioner (363LF0000X) |
United | 81050 | $35.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
United | 81050 | $3.64 | 1609807122 - SPARTANBURG MEDICAL CENTER | 576000934 | SC | General Acute Care Hospital (282N00000X) |
United | 81050 | $1.97 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 81050 | $3.64 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 81050 | $4.80 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | 81050 | $3.27 | 1821544925 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-SENECA | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 81050 | $3.64 | 1689629941 - METHODIST HOSPITALS OF DALLAS, METHODIST MANSFIELD MEDICAL CENTER | 750800661 - METHODIST HOSPITALS OF DALLAS | TX | General Acute Care Hospital (282N00000X) |
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 81050 vs. Other Urinalysis Procedures Codes
The CPT 81050 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 81050 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 |
|---|---|---|
| 80434-CPT | Low | Insulin Tolerance Panel; For Acth Insufficiency This Panel Must Include The Following: Cortisol (82533 X 5) Glucose (82947 X 5) |
| 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 |
| 81050-CPT | Low | Volume Measurement For Timed Collection, Each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81050. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81050 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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