HCPCS 80053

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

Laboratory Work RVU per service none (2021 fee schedule; adds 0 work RVUs)

26,938
99th percentile among 6,253 codes billed · 2021
$288M
99th percentile among 6,253 codes billed · 2021
27.3M
100th percentile among 6,253 codes billed · 2021
109
87th percentile among 6,253 codes billed · 2021
1,229
90th percentile among 6,253 codes billed · 2021
+5.3%
Medicare payment on the code vs 2020; billers +1.4% · 2021

Trend

Medicare payment on the code

$0$200M2020: $273M paid20202021: $288M paid20212022: $279M paid20222023: $279M paid20232024: $280M paid2024$280M$0$200M2020: $273M paid20202021: $288M paid20212022: $279M paid20222023: $279M paid20232024: $280M paid2024$280M$0$200M2020: $273M paid20202021: $288M paid20212022: $279M paid20222023: $279M paid20232024: $280M paid2024$280M$0$200M2020: $273M paid20202021: $288M paid20212022: $279M paid20222023: $279M paid20232024: $280M paid2024$280M

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

Billers

010K20K2020: 27K providers20202021: 27K providers20212022: 27K providers20222023: 26K providers20232024: 26K providers202426K010K20K2020: 27K providers20202021: 27K providers20212022: 27K providers20222023: 26K providers20232024: 26K providers202426K010K20K2020: 27K providers20202021: 27K providers20212022: 27K providers20222023: 26K providers20232024: 26K providers202426K010K20K2020: 27K providers20202021: 27K providers20212022: 27K providers20222023: 26K providers20232024: 26K providers202426K

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
202426,072$280,436,313+1%27,147,672971,1000.00
202326,416$278,792,828-0%26,991,705981,0870.00
202226,774$279,391,219-3%26,843,176991,1130.00
202126,938$287,844,166+5%27,313,9771091,2290.00
202026,557$273,474,790first year in data26,113,5521091,2600.00

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
Florida1,672$31,132,9342,952,5492632,326
Texas2,576$29,354,4182,785,8131461,176
California889$28,953,5242,743,7361613,908
New Jersey499$25,361,3942,405,7421071,445
North Carolina1,358$21,225,9272,013,293105856
New York1,936$14,027,6511,329,8661281,084
Ohio510$11,182,9241,060,275931,109
Arizona559$10,557,1651,001,432891,111
Tennessee1,449$10,249,685974,5891801,190
Alabama758$9,477,598900,3271491,588
Illinois779$8,241,239782,2561141,317
Georgia813$7,985,729757,9021841,145
Kansas333$7,191,714681,7641661,214
Pennsylvania255$6,766,430641,663983,573
Maryland464$5,832,314553,3942391,600

Not listed: 5 billers with an armed-forces or unknown state code (AA, AE, XX, ZZ); they are in the national totals.

Not listed: 4 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,354$36,379,8483,449,712133
Burlington, NC43$15,940,6421,511,32369
Los Angeles-Long Beach-Anaheim, CA483$14,330,4701,358,221154
Tampa-St. Petersburg-Clearwater, FL141$13,912,2201,319,239285
Dallas-Fort Worth-Arlington, TX625$11,860,3231,125,279212
Phoenix-Mesa-Chandler, AZ269$9,960,293944,708103
Chicago-Naperville-Elgin, IL-IN587$7,735,226734,19287
Birmingham, AL144$6,967,767660,879151
Miami-Fort Lauderdale-West Palm Beach, FL186$6,823,940646,680513
Houston-Pasadena-The Woodlands, TX368$6,712,931636,91480
Columbus, OH276$6,634,027628,87980
San Diego-Chula Vista-Carlsbad, CA47$5,845,782553,789893
Austin-Round Rock-San Marcos, TX342$5,842,813554,026146
Atlanta-Sandy Springs-Roswell, GA278$5,684,645538,771128
Kansas City, MO-KS148$5,660,568536,434161

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 89 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.

Specialties billing 80053 nationally

Clinical Laboratory accounts for 73% of payment for 80053 nationally in 2021, across 40 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory1,2814.8%$210,801,68073%19,985,83615,602
Internal Medicine5,06519%$18,498,1286.4%1,757,863347
Family Practice7,09826%$16,940,8895.9%1,611,030227
Hematology-Oncology1,5845.9%$15,211,8505.3%1,446,829913
Pathology860.32%$4,875,3341.7%463,7265,392
Nurse Practitioner4,69617%$4,841,4711.7%460,57598
Medical Oncology5322.0%$4,679,2361.6%445,080837
Rheumatology6292.3%$2,579,6420.90%246,739392
Endocrinology5682.1%$2,214,2090.77%210,743371
Physician Assistant2,1407.9%$1,904,9470.66%181,17785
Cardiology5201.9%$1,276,5210.44%121,227233
Nephrology3211.2%$693,4780.24%66,077206
Gastroenterology4451.7%$565,4740.20%54,421122
Hematology330.12%$490,6180.17%46,6271,413
General Practice1290.48%$399,3580.14%37,972294

Not listed: 28 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 2021.

Top billers of 80053 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