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    v1.0.30
    OpenPayerBilling CodesChemistry ProceduresCPT cpt-82043-urine-albumin-quantitation-kidney-disease
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    CPT 82043: Urine Albumin Quantitative Assay

    Commercial payers pay $18 on average nationally for this procedure.

    CPT code 82043 describes a laboratory test in which a lab analyst quantitates albumin in a timed or random urine specimen to assess urinary albumin excretion, a diagnostic and monitoring assay for kidney disease; service type: clinical laboratory quantitative assay; typical site of service: hospital or independent clinical laboratory where urine specimens are collected and analyzed.

    For related coverage guidance, see recent payer policy updates: Diabetic Supplies, Radiofrequency Ablation for Thyroid Nodules, Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Idaho Only).

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    National Reimbursement Benchmarks

    National commercial reimbursement for CPT 82043 centers around an average commercial benchmark represented by BUCA at $18.50. Blue Cross Blue Shield shows the highest central tendency with a median of $25.10 and a mean of $27.40, while Aetna, Cigna, and UnitedHealth Group cluster lower with means of $7.80, $6.60, and $5.10 respectively. BUCA’s average sits between those clusters and helps frame the market midpoint for commercial contracts at $18.50.

    Dispersion varies notably: Blue Cross Blue Shield has the widest interquartile spread (P75–P25 = $9.80), indicating greater variability across its contracted rates, while UnitedHealth Group is the tightest with a spread of $3.40. Aetna and Cigna show moderate spreads of $4.90 and $4.50 respectively, suggesting more consistent pricing than Blue Cross Blue Shield but less consistency than UnitedHealth Group. BUCA provides a single average benchmark without quartile extremes.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient with long-standing type 2 diabetes and hypertension presents for routine chronic disease management. The clinician orders a urine albumin test to screen for diabetic kidney disease and to quantify albuminuria after a recent elevated dipstick result. A clean-catch random urine specimen is collected at the outpatient clinic and sent to the clinical laboratory. The laboratory analyst performs a timed or random urine albumin quantitation (82043) and reports the microalbumin concentration, often paired with urine creatinine (82570) to calculate an albumin-to-creatinine ratio when indicated. Results are routed to the ordering provider (family medicine or internal medicine) and documented in the medical record to guide staging of chronic kidney disease and monitoring of disease progression or response to therapy.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    82044Albumin; urine, microalbumin, semiquantitativeAlternative semiquantitative method for urine albumin screening; may be used in point-of-care settings instead of 82043.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    291U00000X
    207Q00000X
    207R00000X
    246RM2200X
    2080P0210X
    156FC0800X
    291900000X
    363A00000X

    Related Payer Policy Updates

    Specialty: Endocrinology1 / 3

    10 rows

    PolicyPayerEffective Date
    Diabetic SuppliesCigna2026-10-15
    Radiofrequency Ablation for Thyroid NodulesCigna2026-10-15
    Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Idaho Only)UnitedHealthcare2026-10-01
    Tzield (teplizumab-mzwv) CoverageUnitedHealthcare2026-10-01
    Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Indiana Only)UnitedHealthcare2026-10-01
    Medical Necessity Guidelines Insulin PumpsMass General Brigham Health Plan2026-10-01
    Medical Necessity Guidelines: Continuous Glucose MonitorsMass General Brigham Health Plan2026-10-01
    Continuous Glucose MonitoringAmbetter Nevada2026-10-01
    Salivary Hormone TestingOscar Health2026-10-01
    Bone Turnover Markers TestingOscar Health2026-10-01

    Related Codes

    CPT-82009-KETONE-BODIES-QUALITATIVE-TEST

    CPT 82009: Qualitative Ketone Bodies Test

    CPT-82010-QUANTITATIVE-KETONE-BODIES-ASSAY-SERUM-PLASMA

    CPT 82010: Quantitative Ketone Bodies in Serum or Plasma

    CPT-82013-ACETYLCHOLINESTERASE-QUANTITATIVE-ASSAY

    CPT 82013: Quantitative Acetylcholinesterase (Acetylhydrolase) Assay

    CPT-82016-QUALITATIVE-ACYLCARNITINES-METABOLIC-SCREEN

    CPT 82016: Qualitative Acylcarnitines, Plasma/Serum/Urine

    CPT-82017-QUANTITATIVE-ACYLCARNITINE-ANALYSIS

    CPT 82017: Quantitative Acylcarnitine Analysis

    CPT-82024-QUANTITATIVE-CORTICOTROPIN-ACTH-ASSAY

    CPT 82024: Adrenocorticotropic Hormone (ACTH) Quantitative Assay

    CPT-82030-QUANTITATIVE-CAMP-PLASMA-URINE-ASSAY

    CPT 82030: Quantitative cyclic AMP assay on plasma or urine

    CPT-82040-QUANTITATIVE-ALBUMIN-MEASUREMENT

    CPT 82040: Quantitative Albumin Measurement

    CPT-82042-QUANTITATIVE-ALBUMIN-NONBLOOD-FLUID

    CPT 82042: Albumin Quantitation in Non-Blood Body Fluid

    CPT-82044-POINT-OF-CARE-URINE-MICROALBUMIN-SEMIQUANTITATIVE

    CPT 82044: Semiquantitative Urine Albumin (Microalbumin) Strip Test

    Showing 1–10 of 411

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    82570
    Creatinine; other source
    Often performed on the same urine specimen to calculate albumin-to-creatinine ratio for standardized assessment of albuminuria.
    84156Protein, total, except by refractometry; other sourceProvides total urine protein measurement which can complement specific albumin quantitation in proteinuria assessment.
    81001Urinalysis, automated, with microscopyCommonly performed alongside urine albumin to evaluate urine sediment and detect infection or hematuria that may influence interpretation.