HCPCS 81238

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

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

47
56th percentile among 6,253 codes billed · 2021
$19M
91st percentile among 6,253 codes billed · 2021
31K
76th percentile among 6,253 codes billed · 2021
226
92nd percentile among 6,253 codes billed · 2021
2,512
94th percentile among 6,253 codes billed · 2021
+415.2%
Medicare payment on the code vs 2020; billers +95.8% · 2021

Trend

Medicare payment on the code

$0$10M$20M2020: $3.6M paid20202021: $19M paid20212022: $13M paid20222023: $20M paid20232024: $26M paid2024$26M$0$10M$20M2020: $3.6M paid20202021: $19M paid20212022: $13M paid20222023: $20M paid20232024: $26M paid2024$26M$0$10M$20M2020: $3.6M paid20202021: $19M paid20212022: $13M paid20222023: $20M paid20232024: $26M paid2024$26M$0$10M$20M2020: $3.6M paid20202021: $19M paid20212022: $13M paid20222023: $20M paid20232024: $26M paid2024$26M

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

Billers

0502020: 24 providers20202021: 47 providers20212022: 47 providers20222023: 54 providers20232024: 72 providers2024720502020: 24 providers20202021: 47 providers20212022: 47 providers20222023: 54 providers20232024: 72 providers2024720502020: 24 providers20202021: 47 providers20212022: 47 providers20222023: 54 providers20232024: 72 providers2024720502020: 24 providers20202021: 47 providers20212022: 47 providers20222023: 54 providers20232024: 72 providers202472

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
202472$26,487,120+32%45,1302082,4220.00
202354$19,993,919+51%34,0592072,4190.00
202247$13,261,093-29%22,4161052,0990.00
202147$18,562,624+415%30,9932262,5120.00
202024$3,602,976first year in data6,080899180.00

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
Texas24$7,365,97412,2791752,005

Not listed: 10 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
Dallas-Fort Worth-Arlington, TX13$3,927,6006,546189

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 1 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 81238 nationally

Clinical Laboratory accounts for 100% of payment for 81238 nationally in 2021, across 1 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory47100%$18,562,624100%30,993659

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 81238 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