HCPCS 81238
Laboratory test (ClaimLight category; the code descriptor is not shown)
Laboratory Work RVU per service none (2022 fee schedule; adds 0 work RVUs)
Trend
Medicare payment on the code
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.
Billers
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 | |
|---|---|---|---|---|---|---|---|
| 2024 | 72 | $26,487,120 | +32% | 45,130 | 208 | 2,422 | 0.00 |
| 2023 | 54 | $19,993,919 | +51% | 34,059 | 207 | 2,419 | 0.00 |
| 2022 | 47 | $13,261,093 | -29% | 22,416 | 105 | 2,099 | 0.00 |
| 2021 | 47 | $18,562,624 | +415% | 30,993 | 226 | 2,512 | 0.00 |
| 2020 | 24 | $3,602,976 | first year in data | 6,080 | 89 | 918 | 0.00 |
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 | |
|---|---|---|---|---|---|---|
| Florida | 17 | $5,762,255 | 9,756 | 95 | 2,054 | |
| Texas | 18 | $3,423,425 | 5,811 | 92 | 1,031 |
Not listed: 6 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 | |
|---|---|---|---|---|---|
| Miami-Fort Lauderdale-West Palm Beach, FL | 11 | $3,436,841 | 5,824 | 75 |
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 2022.
Specialties billing 81238 nationally
Clinical Laboratory accounts for 100% of payment for 81238 nationally in 2022, across 1 specialties on claims.
| observed | calculated | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|---|
| Clinical Laboratory | 47 | 100% | $13,261,093 | 100% | 22,416 | 477 |
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 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