HCPCS 84403

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

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

2,949
92nd percentile among 6,253 codes billed · 2021
$29M
94th percentile among 6,253 codes billed · 2021
1.1M
96th percentile among 6,253 codes billed · 2021
43
71st percentile among 6,253 codes billed · 2021
809
86th percentile among 6,253 codes billed · 2021
+11.7%
Medicare payment on the code vs 2020; billers -1.3% · 2021

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
California246$4,085,785159,407871,652
Texas312$3,579,422139,01041759
Florida293$3,525,601136,90539556
Arizona73$2,635,404102,195565,644
New Jersey66$2,222,54586,218824,338
North Carolina128$1,978,28976,78232207
New York246$1,155,42744,87546650
Tennessee165$995,05638,83133477
Georgia150$957,60937,15432239
Alabama121$898,25835,01241314
Ohio52$876,90134,044341,885
Kansas36$602,71223,402671,441
Massachusetts27$587,35922,768416,551
Pennsylvania25$415,78516,126953,791
Illinois45$408,93215,88936503

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
New York-Newark-Jersey City, NY-NJ274$3,261,988126,55453
Los Angeles-Long Beach-Anaheim, CA178$2,413,12494,52371
Tampa-St. Petersburg-Clearwater, FL23$2,040,50179,18732
Dallas-Fort Worth-Arlington, TX113$1,384,06353,75845
Phoenix-Mesa-Chandler, AZ34$1,379,60653,53278
Yuma, AZ13$1,236,42847,9053,792
Houston-Pasadena-The Woodlands, TX46$946,25236,73345
Austin-Round Rock-San Marcos, TX25$913,31535,43922
Atlanta-Sandy Springs-Roswell, GA68$808,00531,31534
Miami-Fort Lauderdale-West Palm Beach, FL73$772,04829,95950
Birmingham, AL46$765,00129,74140
Boston-Cambridge-Newton, MA-NH26$582,83922,59243
Kansas City, MO-KS28$531,79720,64228
Columbus, OH17$491,97919,09821
Nashville-Davidson--Murfreesboro--Franklin, TN26$472,98118,40127

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 55 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 84403 nationally

Clinical Laboratory accounts for 75% of payment for 84403 nationally in 2021, across 13 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory47216%$22,097,65175%858,5671,819
Urology78327%$2,079,3667.1%81,069104
Nurse Practitioner1394.7%$1,176,5434.0%45,661328
Internal Medicine53318%$914,9253.1%35,63467
Pathology401.4%$827,4902.8%32,194805
Family Practice40314%$736,6152.5%28,78971
Endocrinology1866.3%$335,5961.1%13,11270
Medical Oncology391.3%$257,5180.87%10,002256
Hematology-Oncology1113.8%$227,5290.77%8,86680
Physician Assistant1053.6%$218,4600.74%8,49681
General Practice200.68%$78,1850.27%3,043152
Obstetrics & Gynecology270.92%$45,9250.16%1,79566
Cardiology160.54%$43,0330.15%1,672105

Not listed: 22 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 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