HCPCS 81405

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

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

96
65th percentile among 6,253 codes billed · 2021
$61M
96th percentile among 6,253 codes billed · 2021
201K
89th percentile among 6,253 codes billed · 2021
394
94th percentile among 6,253 codes billed · 2021
7,618
97th percentile among 6,253 codes billed · 2021
+92.7%
Medicare payment on the code vs 2020; billers +2.1% · 2021

Trend

Medicare payment on the code

$0$25M$50M2020: $31M paid20202021: $61M paid20212022: $1.5M paid2022$1.5M$0$25M$50M2020: $31M paid20202021: $61M paid20212022: $1.5M paid2022$1.5M$0$25M$50M2020: $31M paid20202021: $61M paid20212022: $1.5M paid2022$1.5M$0$25M$50M2020: $31M paid20202021: $61M paid20212022: $1.5M paid2022$1.5M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2023.

Billers

0501002020: 94 providers20202021: 96 providers20212022: 28 providers20222023: 1 providers202310501002020: 94 providers20202021: 96 providers20212022: 28 providers20222023: 1 providers202310501002020: 94 providers20202021: 96 providers20212022: 28 providers20222023: 1 providers202310501002020: 94 providers20202021: 96 providers20212022: 28 providers20222023: 1 providers20231

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2023.

observed calculated calculated calculated calculated calculated reported
20231fewer than 11 billers: figures not shown0.00
202228$1,493,744-98%4,966625880.00
202196$60,528,966+93%201,0363947,6180.00
202094$31,404,160first year in data104,4992516,7890.00

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2023.

By state

observed calculated calculated calculated calculated calculated
Texas42$46,463,926154,2955738,173
Florida15$5,948,66619,7402465,318

Not listed: 11 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$37,958,148126,0681,868
Dallas-Fort Worth-Arlington, TX19$8,011,08626,584554
Miami-Fort Lauderdale-West Palm Beach, FL11$5,028,34316,686246

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 81405 nationally

Clinical Laboratory accounts for 100% of payment for 81405 nationally in 2021, across 1 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory96100%$60,528,966100%201,0362,094

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 81405 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