HCPCS 84403

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

Laboratory Work RVU per service none (2023 fee schedule; adds 0 work RVUs)

3,039
93rd percentile among 6,405 codes billed · 2023
$30M
94th percentile among 6,405 codes billed · 2023
1.2M
96th percentile among 6,405 codes billed · 2023
39
68th percentile among 6,405 codes billed · 2023
766
84th percentile among 6,405 codes billed · 2023
-1.8%
Medicare payment on the code vs 2022; billers +3.1% · 2023

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
California217$4,410,587175,422802,189
Texas331$3,908,958154,94340857
Florida214$3,706,727146,66242911
North Carolina127$2,557,745101,38530238
New Jersey111$2,458,59797,37153646
Arizona70$1,883,52974,599383,073
New York231$1,158,76645,94349614
Ohio58$953,62637,809281,969
Alabama134$936,91037,31437386
Georgia147$818,61632,42230150
Kansas37$646,66425,586591,463
Tennessee193$627,16024,98828446
Massachusetts39$605,33123,964386,820
Illinois47$425,79516,87242373
Oklahoma77$422,06816,75040489

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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ290$3,492,869138,33556
Los Angeles-Long Beach-Anaheim, CA162$2,436,08797,23275
Tampa-St. Petersburg-Clearwater, FL15$2,238,36588,54558
Dallas-Fort Worth-Arlington, TX121$1,543,60061,18748
Phoenix-Mesa-Chandler, AZ35$1,402,20755,56270
Houston-Pasadena-The Woodlands, TX55$1,047,20241,46837
Austin-Round Rock-San Marcos, TX30$995,99439,46926
Birmingham, AL57$803,37431,95141
Miami-Fort Lauderdale-West Palm Beach, FL65$794,40831,42257
Atlanta-Sandy Springs-Roswell, GA72$682,75827,00732
Kansas City, MO-KS36$622,06724,60526
Boston-Cambridge-Newton, MA-NH30$584,05723,11864
Columbus, OH13$508,31120,15926
Chicago-Naperville-Elgin, IL-IN36$424,78016,82544
Memphis, TN-MS-AR52$397,49515,83774

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 53 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing 84403 nationally

Clinical Laboratory accounts for 79% of payment for 84403 nationally in 2023, across 14 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory48516%$23,831,44579%945,0781,949
Urology81627%$1,958,4386.5%77,92695
Pathology431.4%$830,5152.8%32,979767
Internal Medicine48816%$812,4632.7%32,27566
Family Practice40413%$550,9171.8%21,98254
Nurse Practitioner2277.5%$522,5341.7%20,76891
Physician Assistant1394.6%$411,5261.4%16,345118
Endocrinology1805.9%$280,8200.94%11,19662
Hematology-Oncology973.2%$202,5180.68%8,04983
General Practice160.53%$133,8190.45%5,295331
Medical Oncology280.92%$107,5410.36%4,269152
Obstetrics & Gynecology240.79%$45,1490.15%1,80375
Cardiology180.59%$43,3010.14%1,71595
Radiation Oncology160.53%$25,2800.08%1,00363

Not listed: 21 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 2023.

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