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81007 Urine screen for bacteria

What 81007 is

CMS fee schedule short descriptor: Urine screen for bacteria.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 81007 (CY2026)

This code has no Physician Fee Schedule rate: Statutory exclusion - not payable under the Physician Fee Schedule. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps 81007 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Analyte. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 81007? These codes are bundled into it

81007 is a Column 1 code in 5 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
81000Urinalysis nonauto w/scope0 - no modifier bypassCheck pair
81015Microscopic exam of urine0 - no modifier bypassCheck pair
87086Urine culture/colony count1 - modifier may bypassCheck pair
87088Urine bacteria culture1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

81007 is bundled into these codes

81007 appears as a Column 2 code in 4 active edits. Reported with one of these Column 1 codes on the same date of service, 81007 is the code that denies.

Column 1 codeShort descriptionModifier indicator
81001Urinalysis auto w/scope0Check pair
81002Urinalysis nonauto w/o scope0Check pair
81003Urinalysis auto w/o scope0Check pair
81005Urinalysis0Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.