HCPCS 81403

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

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

87
64th percentile among 6,253 codes billed · 2021
$23M
92nd percentile among 6,253 codes billed · 2021
122K
86th percentile among 6,253 codes billed · 2021
160
91st percentile among 6,253 codes billed · 2021
4,871
96th percentile among 6,253 codes billed · 2021
–
Not compared: 2021 changed office visit values · 2021

Trend

Medicare payment on the code

$0$10M$20M2020: $8.7M paid20202021: $23M paid20212022: $677K paid2022$677K$0$10M$20M2020: $8.7M paid20202021: $23M paid20212022: $677K paid2022$677K$0$10M$20M2020: $8.7M paid20202021: $23M paid20212022: $677K paid2022$677K$0$10M$20M2020: $8.7M paid20202021: $23M paid20212022: $677K paid2022$677K

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

Billers

0501002020: 129 providers20202021: 87 providers20212022: 24 providers20222023: 1 providers20232024: 1 providers202410501002020: 129 providers20202021: 87 providers20212022: 24 providers20222023: 1 providers20232024: 1 providers202410501002020: 129 providers20202021: 87 providers20212022: 24 providers20222023: 1 providers20232024: 1 providers202410501002020: 129 providers20202021: 87 providers20212022: 24 providers20222023: 1 providers20232024: 1 providers20241

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
20241fewer than 11 billers: figures not shown0.00
20231fewer than 11 billers: figures not shown0.00
202224$677,351-97%3,658433540.00
202187$22,573,763– (Not compared: 2021 changed office visit values)121,8921604,8710.00
2020129$8,673,073first year in data47,698891,0130.00

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
Texas39$19,666,347106,1933937,815
Florida12$1,045,8245,6481332,040

Not listed: 13 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
Houston-Pasadena-The Woodlands, TX18$16,210,83487,533622
Dallas-Fort Worth-Arlington, TX17$3,141,18216,962304

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 2 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 81403 nationally

Clinical Laboratory accounts for 100% of payment for 81403 nationally in 2021, across 1 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory87100%$22,573,763100%121,8921,401

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 81403 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