How much does Medicare pay for CPT 81002?

Medicare allowed an average of $3.39 per service and paid $3.39 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $14.99, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 81002?

Urinalysis, manual test. It was billed 1,948,017 times to 1,446,409 Medicare beneficiaries by 28,951 providers in 2024.

Does 81002 pay differently in an office than a hospital?

Yes. The allowed amount averaged $3.39 in an office setting and $3.41 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 81002 most?

Urology, with 583,935 services from 1,798 clinicians. Next are Family Practice, Nurse Practitioner, Internal Medicine.

CPT 81002

Urinalysis, manual test

$3.39Medicare-allowed amount per service, averaged across 1,948,017 services

Providers submitted

$14.99

Asking price, not received

Medicare allowed

$3.39

The fee schedule figure

Medicare paid

$3.39

Balance is patient coinsurance

Providers submitted an average of $14.99 for this code and Medicare allowed $3.39 — 4.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $3.39 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $3.39
Hospital / facility: $3.41

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 1,947,896 services were billed in an office setting and 121 in a facility.

Services: 1,948,017
Beneficiaries: 1,446,409
Providers billing it: 28,951
Total allowed: $6,603,778

What Medicare pays for CPT 81002

Across 1,948,017 services billed by 28,951 providers to 1,446,409 beneficiaries, Medicare allowed an average of $3.39 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 81002

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	583,935	379,760	$3.39	1,798
Family Practice	357,765	274,766	$3.39	7,435
Nurse Practitioner	305,129	249,400	$3.39	7,911
Internal Medicine	277,504	210,817	$3.40	4,431
Physician Assistant	152,551	130,943	$3.39	3,811
Obstetrics & Gynecology	119,345	95,206	$3.39	1,592
Clinical Laboratory	28,352	20,011	$3.41	91
Nephrology	27,863	18,873	$3.39	332
Emergency Medicine	24,182	21,408	$3.40	522
General Practice	16,556	11,153	$3.40	237
Hematology-Oncology	11,653	5,787	$3.40	236
Rheumatology	7,882	4,470	$3.39	60
Endocrinology	5,647	3,106	$3.41	26
Cardiology	5,144	3,502	$3.40	47
Medical Oncology	2,905	1,619	$3.39	60

81002 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	209,476	$3.40	$3.41	1,843
Florida	186,390	$3.40	$3.41	2,360
California	176,410	$3.40	$3.41	2,396
Texas	119,327	$3.40	$3.41	1,723
New Jersey	90,207	$3.40	$3.41	1,162
Pennsylvania	83,737	$3.40	$3.41	1,404
Arizona	82,459	$3.39	$3.41	1,038
Georgia	81,269	$3.39	$3.41	1,247
Virginia	73,244	$3.39	$3.41	926
Ohio	72,503	$3.39	$3.41	1,412
Maryland	62,963	$3.38	$3.41	833
Tennessee	55,479	$3.37	$3.41	786
Michigan	51,751	$3.38	$3.41	930
South Carolina	51,054	$3.40	$3.41	431
Massachusetts	49,610	$3.41	$3.41	946
North Carolina	49,532	$3.39	$3.41	816
Alabama	44,302	$3.37	$3.41	718
Illinois	38,927	$3.40	$3.41	951
Connecticut	26,908	$3.40	$3.41	429
Indiana	26,447	$3.39	$3.41	595
Missouri	25,728	$3.38	$3.41	428
Kentucky	23,128	$3.38	$3.41	457
Arkansas	22,072	$3.39	$3.41	268
Colorado	22,051	$3.39	$3.41	472
Mississippi	21,963	$3.38	$3.41	279
Washington	21,548	$3.38	$3.41	520
Nevada	20,977	$3.38	$3.41	331
Kansas	19,742	$3.40	$3.41	351
Louisiana	16,088	$3.39	$3.41	268
Oregon	14,393	$3.36	$3.39	308
Oklahoma	13,764	$3.40	$3.41	318
New Mexico	10,901	$3.39	$3.41	188
Utah	8,458	$3.39	$3.41	169
Wisconsin	8,065	$3.37	$3.41	106
Iowa	6,405	$3.39	$3.41	160
West Virginia	6,324	$3.39	$3.41	162
Nebraska	5,791	$3.39	$3.41	118
Delaware	5,764	$3.40	$3.41	110
Wyoming	5,596	$3.39	$3.41	72
Hawaii	5,318	$3.33	$3.41	68
Idaho	5,051	$3.39	$3.41	161
Minnesota	4,892	$3.38	$3.41	64
Rhode Island	4,507	$3.39	$3.41	136
New Hampshire	3,794	$3.41	$3.41	133
District of Columbia	3,020	$3.38	$3.41	40
Vermont	2,251	$3.41	$3.41	85
Montana	2,164	$3.40	$3.41	74
Alaska	1,966	$3.41	$3.41	68
Maine	1,480	$3.40	$3.41	51
Puerto Rico	1,059	$3.40	$3.41	2
North Dakota	855	$3.40	$3.41	13
South Dakota	393	$3.39	$3.41	10
U.S. Virgin Islands	220	$3.41	$3.41	7
AE	95	$3.41	$3.41	2
Guam	92	$3.41	$3.41	4
AP	57	$3.41	$3.41	1

Related codes

81001Manual urinalysis test$3.10
81003Automated urinalysis test$2.19
81000Manual urinalysis test$3.92
81007Urinalysis for bacteria$29.27
81015Urinalysis using microscope$2.98
81050Urine volume measurement$3.57
81005Analysis of urine$2.13
81025Urine pregnancy test$8.33

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.