HCPCS 82043

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

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

10,266
97th percentile among 6,253 codes billed · 2021
$21M
92nd percentile among 6,253 codes billed · 2021
3.6M
98th percentile among 6,253 codes billed · 2021
37
67th percentile among 6,253 codes billed · 2021
364
77th percentile among 6,253 codes billed · 2021
+6.6%
Medicare payment on the code vs 2020; billers +1.4% · 2021

Trend

Medicare payment on the code

$0$10M$20M2020: $19M paid20202021: $21M paid20212022: $21M paid20222023: $23M paid20232024: $25M paid2024$25M$0$10M$20M2020: $19M paid20202021: $21M paid20212022: $21M paid20222023: $23M paid20232024: $25M paid2024$25M$0$10M$20M2020: $19M paid20202021: $21M paid20212022: $21M paid20222023: $23M paid20232024: $25M paid2024$25M$0$10M$20M2020: $19M paid20202021: $21M paid20212022: $21M paid20222023: $23M paid20232024: $25M paid2024$25M

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

Billers

05,00010K2020: 10K providers20202021: 10K providers20212022: 10K providers20222023: 11K providers20232024: 12K providers202412K05,00010K2020: 10K providers20202021: 10K providers20212022: 10K providers20222023: 11K providers20232024: 12K providers202412K05,00010K2020: 10K providers20202021: 10K providers20212022: 10K providers20222023: 11K providers20232024: 12K providers202412K05,00010K2020: 10K providers20202021: 10K providers20212022: 10K providers20222023: 11K providers20232024: 12K providers202412K

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
202411,597$24,993,863+10%4,427,155373450.00
202310,795$22,682,640+8%4,019,184373500.00
202210,434$20,996,642+2%3,690,385363410.00
202110,266$20,601,716+7%3,575,288373640.00
202010,125$19,321,426first year in data3,377,286383690.00

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
California287$2,705,264468,325755,149
Florida571$2,110,817368,82669642
New Jersey169$2,008,827347,808451,233
Texas728$1,924,217333,58738311
North Carolina643$1,653,548286,42542223
Arizona229$846,395146,74137288
Ohio306$747,869129,32537251
New York624$747,305129,62940347
Massachusetts472$614,228106,38852242
Illinois303$525,30091,23935403
Alabama243$516,39889,75644344
Georgia386$513,29989,12148442
Pennsylvania128$512,83888,829413,487
Kansas131$486,92884,32636169
Tennessee410$461,74380,42543240

Not listed: 2 billers with an armed-forces or unknown state code (XX, ZZ); they are in the national totals.

Not listed: 5 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
New York-Newark-Jersey City, NY-NJ474$2,604,868451,10848
Los Angeles-Long Beach-Anaheim, CA136$1,273,294220,45861
Tampa-St. Petersburg-Clearwater, FL41$1,272,465220,50351
Burlington, NC15$1,265,256218,98754
Phoenix-Mesa-Chandler, AZ83$794,868137,78652
Dallas-Fort Worth-Arlington, TX127$777,702134,82338
San Diego-Chula Vista-Carlsbad, CA14$563,57297,543550
Houston-Pasadena-The Woodlands, TX120$536,30392,90931
Boston-Cambridge-Newton, MA-NH352$526,75791,19244
Chicago-Naperville-Elgin, IL-IN242$517,28689,85733
Columbus, OH185$495,72085,84737
Birmingham, AL99$441,60776,53044
Kansas City, MO-KS81$434,44775,23442
Austin-Round Rock-San Marcos, TX145$414,12271,73836
Baltimore-Columbia-Towson, MD115$347,95560,34549

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 78 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 82043 nationally

Clinical Laboratory accounts for 80% of payment for 82043 nationally in 2021, across 14 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory7587.4%$16,459,59680%2,854,1233,765
Internal Medicine3,13731%$1,449,0727.0%252,21480
Family Practice3,83337%$1,310,5836.4%228,19160
Endocrinology4764.6%$381,0831.8%66,370139
Pathology350.34%$305,2901.5%53,0751,516
Nurse Practitioner1,13511%$263,8311.3%45,92840
Nephrology1741.7%$171,7370.83%29,950172
Physician Assistant5004.9%$109,4300.53%19,02338
Cardiology270.26%$37,1560.18%6,468240
General Practice550.54%$29,5610.14%5,14394
Pediatric Medicine210.20%$15,2240.07%2,646126
Emergency Medicine220.21%$8,0580.04%1,39964
Geriatric Medicine130.13%$6,4520.03%1,12186
Pulmonary Disease120.12%$1,867<0.01%32327

Not listed: 18 specialties with fewer than 11 billers (small cells).

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 82043 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