HCPCS 84403

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

Laboratory Work RVU per service none (2022 fee schedule; adds 0 work RVUs)

2,947
92nd percentile among 6,326 codes billed · 2022
$31M
94th percentile among 6,326 codes billed · 2022
1.2M
96th percentile among 6,326 codes billed · 2022
41
70th percentile among 6,326 codes billed · 2022
804
86th percentile among 6,326 codes billed · 2022
+3.7%
Medicare payment on the code vs 2021; billers -0.1% · 2022

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
California229$4,145,737163,715831,840
Texas323$3,757,356147,82838794
Arizona77$3,636,735143,0854013,372
Florida249$3,499,639137,47639674
New Jersey98$2,373,18593,260571,744
North Carolina132$1,971,50077,49131199
New York214$1,164,97445,80147756
Tennessee166$1,051,48441,54129473
Ohio57$918,38336,201321,993
Alabama136$909,69635,88940311
Georgia149$764,43030,04130142
Kansas38$642,41725,262671,199
Massachusetts37$583,36122,916546,243
Illinois42$407,61716,04441496
Oklahoma73$394,90815,56238591

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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ271$3,403,102133,71852
Los Angeles-Long Beach-Anaheim, CA161$2,466,12997,73976
Tampa-St. Petersburg-Clearwater, FL16$2,044,60580,29043
Dallas-Fort Worth-Arlington, TX116$1,454,70757,22745
Phoenix-Mesa-Chandler, AZ37$1,420,43255,79870
Houston-Pasadena-The Woodlands, TX54$998,31939,23528
Austin-Round Rock-San Marcos, TX26$970,27338,17726
Birmingham, AL57$779,15430,67243
Miami-Fort Lauderdale-West Palm Beach, FL66$756,20029,69152
Atlanta-Sandy Springs-Roswell, GA77$638,34525,05831
Kansas City, MO-KS33$593,55823,34233
Boston-Cambridge-Newton, MA-NH28$563,63422,13678
Nashville-Davidson--Murfreesboro--Franklin, TN22$511,80120,15544
Columbus, OH16$505,29019,85524
Chicago-Naperville-Elgin, IL-IN34$395,86115,58443

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 56 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2022.

Specialties billing 84403 nationally

Clinical Laboratory accounts for 74% of payment for 84403 nationally in 2022, across 14 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory47316%$22,522,07174%886,1421,873
Urology79627%$2,010,1506.6%79,327100
Nurse Practitioner1695.7%$1,331,8324.4%52,417310
Physician Assistant1214.1%$906,2183.0%35,711295
Pathology431.5%$863,2362.8%34,051792
Internal Medicine50917%$823,1302.7%32,46764
Family Practice39313%$557,4571.8%22,10056
General Practice150.51%$403,2921.3%15,8661,058
Endocrinology1846.2%$307,2931.0%12,16066
Hematology-Oncology1073.6%$201,9420.66%7,95474
Medical Oncology341.2%$123,1440.40%4,847143
Obstetrics & Gynecology240.81%$49,6000.16%1,95281
Cardiology140.48%$37,7660.12%1,486106
Radiation Oncology140.48%$20,9460.07%82359

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 2022.

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