CPT 81003
Automated Urinalysis
Priced under CLFS
81003 · PFS Q1 2025 · Historical
Status X is not separately payable under the PFS.
CPT 81003 has no published national rate. It carries status X (statutory exclusion) in the Q1 2025 release. The statutory definition of physician services does not include this item. The blank amount means unpriced, not $0.
PFS status evidence
Inspect PFS status evidence
- Code
- 81003
- Release
- Q1 2025, revision 1
- Result
- Priced under CLFS
Citations
-
Shows this code’s PFS status (X). Result: Priced under CLFS.
Physician relative value file (PPRRVU)Q1 2025 · revision 1
Latest revision of this release
Release period: January 1 – March 31, 2025
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
Record details
PPRRVU25_JAN.csv in rvu25a-updated-01-10-2025.zip (row 15,469)- hcpcs (col 1)
- 81003
- modifier (col 2)
- blank
- status_code (col 4)
- X
SHA-256: c0539b47cbc042fd1b69798e6dd911219f4893bb5be793ae1d1771e7a7151a54
Why is there no national PFS amount for 81003?
Its status indicator is X (statutory exclusion). The statutory definition of physician services does not include this item. Status X is not separately payable under the PFS.
About this code
Also known as Urinalysis
Payment considerations Copy link
Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.
Other payment indicators (9)
Facility/non-facility: Not determined, Professional/technical component: Does not apply, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, NCCI same-day edits: Not determined, MUE behavior: Not determined, Contractor pricing: Does not apply.
Why would a Medicare claim for 81003 be denied or paid less?
These come from CMS indicators on this page, not general billing advice.
- Its status indicator is X (statutory exclusion)—The statutory definition of physician services does not include this item. See status indicators
Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.
Payment review for 81003 Copy link
Urinalysis payment depends on the method used, the lab fee source, and sometimes the specific waived test system. Keep the code, device, and date together throughout the review.
What to check
- Tell manual, automated, and microscopy lines apart before comparing their amounts.
- Check QW status against the named test system and the effective CMS file instead of applying it across the board.
- Keep a same-day E/M line separate, and check current NCCI edits before blaming a denial on bundling.
Sources: CMS Clinical Laboratory Fee Schedule; CMS Clinical Laboratory Improvement Amendments (CLIA); CMS Medicare NCCI Policy Manual (2026).
Which billing rules and modifiers apply? Copy link
Global period: what 81003's fee already covers Copy link
The global surgery concept does not apply to this code.
Can you bill it with another code? Copy link
Check a pair of codes Copy link
Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit for the pair.
How has it changed? Copy link
Rate history by release Copy link
National Office (non-facility) amount for 81003 across quarterly releases.
| Release | Status | Office | Facility |
|---|---|---|---|
| Q4 2026 takes effect Oct 1, 2026 | X | — | — |
| Q3 2026 Jul 1, 2026 – Sep 30, 2026 | X | — | — |
| Q2 2026 Apr 1, 2026 – Jun 30, 2026 | X | — | — |
| Q1 2026 Jan 1, 2026 – Mar 31, 2026 | X | — | — |
| Q4 2025 Oct 1, 2025 – Dec 31, 2025 | X | — | — |
| Q3 2025 Jul 1, 2025 – Sep 30, 2025 | X | — | — |
| Q2 2025 Apr 1, 2025 – Jun 30, 2025 | X | — | — |
| Q1 2025 Jan 1, 2025 – Mar 31, 2025 | X | — | — |
| Q4 2024 Oct 1, 2024 – Dec 31, 2024 | X | — | — |
| Q3 2024 Jul 1, 2024 – Sep 30, 2024 | X | — | — |
| Q2 2024 Apr 1, 2024 – Jun 30, 2024 | X | — | — |
| Q1 2024 Mar 9, 2024 – Mar 31, 2024 | X | — | — |
| Q1 2024 Jan 1, 2024 – Mar 8, 2024 | X | — | — |
| Q4 2023 Oct 1, 2023 – Dec 31, 2023 | X | — | — |
| Q3 2023 Jul 1, 2023 – Sep 30, 2023 | X | — | — |
| Q2 2023 Apr 1, 2023 – Jun 30, 2023 | X | — | — |
| Q1 2023 Jan 1, 2023 – Mar 31, 2023 | X | — | — |
| Q4 2022 Oct 1, 2022 – Dec 31, 2022 | X | — | — |
| Q3 2022 Jul 1, 2022 – Sep 30, 2022 | X | — | — |
| Q2 2022 Apr 1, 2022 – Jun 30, 2022 | X | — | — |
| Q1 2022 Jan 1, 2022 – Mar 31, 2022 | X | — | — |
| Q4 2021 Oct 1, 2021 – Dec 31, 2021 | X | — | — |
| Q3 2021 Jul 1, 2021 – Sep 30, 2021 | X | — | — |
| Q2 2021 Apr 1, 2021 – Jun 30, 2021 | X | — | — |
| Q1 2021 Jan 1, 2021 – Mar 31, 2021 | X | — | — |
| Q4 2020 Oct 1, 2020 – Dec 31, 2020 | X | — | — |
| Q3 2020 Jul 1, 2020 – Sep 30, 2020 | X | — | — |
| Q2 2020 Apr 1, 2020 – Jun 30, 2020 | X | — | — |
| Q1 2020 Jan 1, 2020 – Mar 31, 2020 | X | — | — |
| Q4 2019 Oct 1, 2019 – Dec 31, 2019 | X | — | — |
| Q3 2019 Jul 1, 2019 – Sep 30, 2019 | X | — | — |
| Q2 2019 Apr 1, 2019 – Jun 30, 2019 | X | — | — |
| Q1 2019 Jan 1, 2019 – Mar 31, 2019 | X | — | — |
| Q4 2018 Oct 1, 2018 – Dec 31, 2018 | X | — | — |
| Q3 2018 Jul 1, 2018 – Sep 30, 2018 | X | — | — |
| Q2 2018 Apr 1, 2018 – Jun 30, 2018 | X | — | — |
| Q1 2018 Jan 1, 2018 – Mar 31, 2018 | X | — | — |
| Q4 2017 Oct 1, 2017 – Dec 31, 2017 | X | — | — |
| Q3 2017 Jul 1, 2017 – Sep 30, 2017 | X | — | — |
| Q2 2017 Apr 1, 2017 – Jun 30, 2017 | X | — | — |
| Q1 2017 Jan 1, 2017 – Mar 31, 2017 | X | — | — |
| Q4 2016 Oct 1, 2016 – Dec 31, 2016 | X | — | — |
| Q3 2016 Jul 1, 2016 – Sep 30, 2016 | X | — | — |
| Q2 2016 Apr 1, 2016 – Jun 30, 2016 | X | — | — |
| Q1 2016 Jan 1, 2016 – Mar 31, 2016 | X | — | — |
| Q4 2015 Oct 1, 2015 – Dec 31, 2015 | X | — | — |
| Q3 2015 Jul 1, 2015 – Sep 30, 2015 | X | — | — |
| Q2 2015 Apr 1, 2015 – Jun 30, 2015 | X | — | — |
| Q1 2015 Jan 1, 2015 – Mar 31, 2015 | X | — | — |
| Q4 2014 Oct 1, 2014 – Dec 31, 2014 | X | — | — |
| Q3 2014 Jul 1, 2014 – Sep 30, 2014 | X | — | — |
| Q2 2014 Apr 1, 2014 – Jun 30, 2014 | X | — | — |
| Q2 2013 Apr 1, 2013 – Jun 30, 2013 | X | — | — |
| Q1 2013 Jan 1, 2013 – Mar 31, 2013 | X | — | — |
When does this rate change?
CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
Usage and related codes Copy link
How often 81003 is billed Copy link
Across Original Medicare in CY2024, 81003 ranked #53 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars. It repeats: a patient billed for it in 2024 was billed 1.6 times on average that year.
2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q1 2025 fee schedule above.
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Source & method
Show sources
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This page uses CMS's Medicare Physician Fee Schedule Q1 2025 release (effective January 2025). National baselines use GPCI 1.000 and exclude sequestration. Whether a national amount exists depends on the status and CMS’s payment instructions; blank RVUs are never treated as zero. Past releases are never edited, so these sources stay valid after CMS publishes a newer one. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
The citation names the release, so anyone can check it even after CMS publishes a newer one.
CPT 81003 National PFS baseline: No national PFS rate (Q1 2025; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/81003/2025/A