HCPCS 80053

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

Laboratory Work RVU per service none (2022 fee schedule; adds 0 work RVUs)

26,774
99th percentile among 6,326 codes billed · 2022
$279M
99th percentile among 6,326 codes billed · 2022
26.8M
100th percentile among 6,326 codes billed · 2022
99
86th percentile among 6,326 codes billed · 2022
1,113
89th percentile among 6,326 codes billed · 2022
-2.9%
Medicare payment on the code vs 2021; billers -0.6% · 2022

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
Florida1,623$30,283,8522,906,3772251,501
California927$28,496,8062,734,1271323,610
Texas2,553$28,462,8092,734,4261351,038
New Jersey514$27,432,2532,635,1371071,457
North Carolina1,351$20,734,3681,991,269101842
New York2,015$13,292,8061,276,620110977
Ohio535$10,440,1911,002,976941,166
Arizona599$10,299,191988,97387972
Tennessee1,552$9,714,307935,3281461,094
Alabama670$8,862,252852,4661371,537
Illinois754$7,750,117745,0971011,454
Georgia805$7,582,937728,4571681,050
Kansas346$7,074,556679,0621511,173
Virginia752$6,024,553579,3161891,619
Maryland450$5,776,445554,8252451,628

Not listed: 3 billers with an armed-forces or unknown state code (AA, AE, XX); they are in the national totals.

Not listed: 3 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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,398$37,615,5313,612,597125
Burlington, NC42$15,465,5851,484,94070
Los Angeles-Long Beach-Anaheim, CA516$14,141,9111,356,860128
Tampa-St. Petersburg-Clearwater, FL131$13,700,0421,314,578272
Dallas-Fort Worth-Arlington, TX605$11,777,5521,131,423175
Phoenix-Mesa-Chandler, AZ323$9,759,655936,98584
Chicago-Naperville-Elgin, IL-IN559$7,330,523704,80484
Birmingham, AL139$6,717,679645,364110
Houston-Pasadena-The Woodlands, TX404$6,709,837644,09978
Miami-Fort Lauderdale-West Palm Beach, FL190$6,478,662621,311358
Columbus, OH300$6,121,341587,65178
San Diego-Chula Vista-Carlsbad, CA42$5,975,385573,293751
Kansas City, MO-KS155$5,644,099541,580183
Austin-Round Rock-San Marcos, TX354$5,537,544531,557118
Atlanta-Sandy Springs-Roswell, GA272$5,535,237531,085130

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 2022.

Specialties billing 80053 nationally

Clinical Laboratory accounts for 74% of payment for 80053 nationally in 2022, across 39 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory1,2524.7%$207,714,95774%19,940,44115,927
Internal Medicine4,86918%$16,760,2736.0%1,612,470331
Family Practice7,00126%$15,764,6305.6%1,518,096217
Hematology-Oncology1,5485.8%$13,162,6274.7%1,267,299819
Pathology930.35%$6,036,5332.2%581,5616,253
Nurse Practitioner4,93018%$4,878,2721.7%470,02795
Medical Oncology5081.9%$3,829,7271.4%368,511725
Rheumatology6212.3%$2,422,4040.87%234,566378
Endocrinology5612.1%$2,163,7690.77%208,472372
Physician Assistant2,2758.5%$1,921,3730.69%185,11581
Cardiology4991.9%$1,100,6180.39%105,778212
Nephrology3051.1%$671,4150.24%64,746212
Gastroenterology3641.4%$495,9730.18%48,354133
Hematology320.12%$448,7540.16%43,1301,348
General Practice1150.43%$315,4290.11%30,346264

Not listed: 30 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 2022.

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