HCPCS 84403

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

Laboratory Work RVU per service none (2024 fee schedule; adds 0 work RVUs)

3,085
93rd percentile among 6,471 codes billed · 2024
$32M
94th percentile among 6,471 codes billed · 2024
1.3M
96th percentile among 6,471 codes billed · 2024
40
67th percentile among 6,471 codes billed · 2024
736
82nd percentile among 6,471 codes billed · 2024
+5.5%
Medicare payment on the code vs 2023; billers +1.5% · 2024

Trend

Medicare payment on the code

$0$20M2020: $26M paid20202021: $29M paid20212022: $31M paid20222023: $30M paid20232024: $32M paid2024$32M$0$20M2020: $26M paid20202021: $29M paid20212022: $31M paid20222023: $30M paid20232024: $32M paid2024$32M$0$20M2020: $26M paid20202021: $29M paid20212022: $31M paid20222023: $30M paid20232024: $32M paid2024$32M$0$20M2020: $26M paid20202021: $29M paid20212022: $31M paid20222023: $30M paid20232024: $32M paid2024$32M

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

Billers

02,0002020: 2,988 providers20202021: 2,949 providers20212022: 2,947 providers20222023: 3,039 providers20232024: 3,085 providers20243,08502,0002020: 2,988 providers20202021: 2,949 providers20212022: 2,947 providers20222023: 3,039 providers20232024: 3,085 providers20243,08502,0002020: 2,988 providers20202021: 2,949 providers20212022: 2,947 providers20222023: 3,039 providers20232024: 3,085 providers20243,08502,0002020: 2,988 providers20202021: 2,949 providers20212022: 2,947 providers20222023: 3,039 providers20232024: 3,085 providers20243,085

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
20243,085$31,636,616+6%1,255,381407360.00
20233,039$29,978,769-2%1,189,510397660.00
20222,947$30,532,309+4%1,202,063418040.00
20212,949$29,447,923+12%1,144,798438090.00
20202,988$26,371,907first year in data1,032,203427430.00

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
California209$4,569,759181,8201151,969
Texas349$4,238,221167,99241781
Florida187$3,941,911155,959441,010
New Jersey82$2,713,651107,440652,495
North Carolina130$2,242,07888,79431200
Arizona58$1,625,07164,40632987
Tennessee220$1,215,43848,35529404
New York271$1,206,48047,80846487
Ohio60$1,048,87841,552361,646
Alabama134$985,92139,19840360
Georgia148$866,43034,32530159
Kansas39$660,43526,125431,184
Massachusetts42$654,24425,897407,036
Illinois36$484,16219,17345960
Washington19$484,02919,156646,390

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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ299$3,795,399150,27151
Los Angeles-Long Beach-Anaheim, CA150$2,627,949104,95396
Tampa-St. Petersburg-Clearwater, FL13$2,455,28897,12340
Dallas-Fort Worth-Arlington, TX118$1,674,59866,36647
Phoenix-Mesa-Chandler, AZ31$1,600,40563,42473
Austin-Round Rock-San Marcos, TX34$1,112,12844,07933
Houston-Pasadena-The Woodlands, TX53$1,088,66743,10331
Miami-Fort Lauderdale-West Palm Beach, FL62$872,93434,52670
Birmingham, AL60$845,62833,56247
Atlanta-Sandy Springs-Roswell, GA67$729,65828,87033
Boston-Cambridge-Newton, MA-NH34$631,52524,99242
Nashville-Davidson--Murfreesboro--Franklin, TN34$613,02524,34433
Kansas City, MO-KS17$607,56924,02833
Columbus, OH23$564,10622,35422
Chicago-Naperville-Elgin, IL-IN29$483,85319,15447

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 54 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2024.

Specialties billing 84403 nationally

Clinical Laboratory accounts for 82% of payment for 84403 nationally in 2024, across 15 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory46715%$25,790,35682%1,022,8082,190
Urology75524%$1,900,5616.0%75,607100
Pathology421.4%$899,7392.8%35,752851
Internal Medicine47115%$797,1902.5%31,63967
Family Practice44414%$560,0981.8%22,33950
Nurse Practitioner31210%$437,7721.4%17,46956
Endocrinology1705.5%$261,7750.83%10,41761
Hematology-Oncology1013.3%$234,3530.74%9,30692
Physician Assistant1484.8%$212,8120.67%8,48857
Medical Oncology341.1%$143,7830.45%5,695168
General Practice140.45%$63,1720.20%2,511179
Cardiology130.42%$54,2740.17%2,149165
Pain Management120.39%$50,2590.16%2,017168
Obstetrics & Gynecology270.88%$31,6320.10%1,27347
Radiation Oncology170.55%$26,0140.08%1,03261

Not listed: 19 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 2024.

Top billers of 84403 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