HCPCS 81404

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

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

100
65th percentile among 6,253 codes billed · 2021
$74M
97th percentile among 6,253 codes billed · 2021
269K
90th percentile among 6,253 codes billed · 2021
465
95th percentile among 6,253 codes billed · 2021
10,588
98th percentile among 6,253 codes billed · 2021
+83.8%
Medicare payment on the code vs 2020; billers +7.5% · 2021

Trend

Medicare payment on the code

$0$50M2020: $40M paid20202021: $74M paid20212022: $1.8M paid2022$1.8M$0$50M2020: $40M paid20202021: $74M paid20212022: $1.8M paid2022$1.8M$0$50M2020: $40M paid20202021: $74M paid20212022: $1.8M paid2022$1.8M$0$50M2020: $40M paid20202021: $74M paid20212022: $1.8M paid2022$1.8M

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

Billers

0501002020: 93 providers20202021: 100 providers20212022: 27 providers20222023: 2 providers20232024: 2 providers202420501002020: 93 providers20202021: 100 providers20212022: 27 providers20222023: 2 providers20232024: 2 providers202420501002020: 93 providers20202021: 100 providers20212022: 27 providers20222023: 2 providers20232024: 2 providers202420501002020: 93 providers20202021: 100 providers20212022: 27 providers20222023: 2 providers20232024: 2 providers20242

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
20242fewer than 11 billers: figures not shown0.00
20232fewer than 11 billers: figures not shown0.00
202227$1,763,398-98%6,426968910.00
2021100$73,846,549+84%268,90646510,5880.00
202093$40,173,056first year in data146,7183659,5580.00

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
Texas42$59,572,274216,8721,10516,244
Florida16$5,082,44418,4952124,456

Not listed: 12 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, TX19$46,504,831169,3214,102
Dallas-Fort Worth-Arlington, TX19$12,229,93544,5001,088
Miami-Fort Lauderdale-West Palm Beach, FL11$4,200,57215,285242

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 3 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 81404 nationally

Clinical Laboratory accounts for 100% of payment for 81404 nationally in 2021, across 1 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory100100%$73,846,549100%268,9062,689

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 81404 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