HCPCS 0240U

Laboratory test (ClaimLight category; the code descriptor is not shown)

Laboratory

184
73rd percentile among 6,405 codes billed · 2023
$28M
94th percentile among 6,405 codes billed · 2023
198K
89th percentile among 6,405 codes billed · 2023
24
51st percentile among 6,405 codes billed · 2023
251
71st percentile among 6,405 codes billed · 2023
+1350.4%
Medicare payment on the code vs 2022; billers -26.4%. 2023 changed hospital and observation visit codes · 2023

Trend

Medicare payment on the code

$0$20M2021: $644K paid20212022: $1.9M paid20222023: $28M paid20232024: $7.7M paid2024$7.7M$0$20M2021: $644K paid20212022: $1.9M paid20222023: $28M paid20232024: $7.7M paid2024$7.7M$0$20M2021: $644K paid20212022: $1.9M paid20222023: $28M paid20232024: $7.7M paid2024$7.7M$0$20M2021: $644K paid20212022: $1.9M paid20222023: $28M paid20232024: $7.7M paid2024$7.7M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

01002002020: 4 providers20202021: 96 providers20212022: 250 providers20222023: 184 providers20232024: 105 providers202410501002002020: 4 providers20202021: 96 providers20212022: 250 providers20222023: 184 providers20232024: 105 providers202410501002002020: 4 providers20202021: 96 providers20212022: 250 providers20222023: 184 providers20232024: 105 providers202410501002002020: 4 providers20202021: 96 providers20212022: 250 providers20222023: 184 providers20232024: 105 providers2024105

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
2024105$7,655,864-72%54,80821104
2023184$27,664,168+1350% (2023 changed hospital and observation visit codes)197,98524251
2022250$1,907,333+196%13,72322141
202196$644,118– (Not compared: 2021 changed office visit values)4,50329144
20204fewer than 11 billers: figures not shown

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
Florida14$3,655,69126,154169,094
Iowa11$90,86765638189
South Dakota15$77,8825583187
Oklahoma16$76,8995573261
Arkansas17$69,8345022756
North Carolina12$45,4293262555
Minnesota15$34,9452501528

Not listed: 21 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2023.

Top metro areas

observed calculated calculated calculated calculated
Oklahoma City, OK13$68,79249838
Rapid City, SD12$47,41034021
Orlando-Kissimmee-Sanford, FL12$27,42119715

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 3 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing 0240U nationally

Clinical Laboratory accounts for 97% of payment for 0240U nationally in 2023, across 5 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory1910%$26,777,76697%191,57610,083
Nurse Practitioner6234%$245,1650.89%1,76729
Internal Medicine137.1%$230,9960.84%1,690130
Family Practice4022%$208,9170.76%1,50238
Physician Assistant3921%$136,1870.49%97825

Not listed: 4 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2023.

Top billers of 0240U nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations