HCPCS 85025

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

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

34,218
99th percentile among 6,253 codes billed · 2021
$208M
99th percentile among 6,253 codes billed · 2021
26.8M
100th percentile among 6,253 codes billed · 2021
93
86th percentile among 6,253 codes billed · 2021
1,420
91st percentile among 6,253 codes billed · 2021
–
Not compared: 2021 changed office visit values · 2021

Trend

Medicare payment on the code

$0$100M$200M2020: $201M paid20202021: $208M paid20212022: $201M paid20222023: $198M paid20232024: $198M paid2024$198M$0$100M$200M2020: $201M paid20202021: $208M paid20212022: $201M paid20222023: $198M paid20232024: $198M paid2024$198M$0$100M$200M2020: $201M paid20202021: $208M paid20212022: $201M paid20222023: $198M paid20232024: $198M paid2024$198M$0$100M$200M2020: $201M paid20202021: $208M paid20212022: $201M paid20222023: $198M paid20232024: $198M paid2024$198M

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

Billers

020K2020: 35K providers20202021: 34K providers20212022: 33K providers20222023: 33K providers20232024: 32K providers202432K020K2020: 35K providers20202021: 34K providers20212022: 33K providers20222023: 33K providers20232024: 32K providers202432K020K2020: 35K providers20202021: 34K providers20212022: 33K providers20222023: 33K providers20232024: 32K providers202432K020K2020: 35K providers20202021: 34K providers20212022: 33K providers20222023: 33K providers20232024: 32K providers202432K

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
202432,034$198,275,222-0%26,108,717871,3300.00
202332,833$198,465,892-1% (2023 changed hospital and observation visit codes)26,138,972891,3480.00
202233,355$200,531,883-4%26,201,444901,3650.00
202134,218$208,012,404– (Not compared: 2021 changed office visit values)26,835,452931,4200.00
202034,803$200,768,897first year in data26,076,372911,3810.00

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
Florida1,945$23,092,1662,977,3752653,201
California1,165$21,128,4592,721,4462223,742
Texas2,851$19,888,9212,565,3261271,214
New Jersey690$16,251,9942,095,4161672,177
North Carolina2,048$13,542,0901,745,41481887
New York2,194$11,090,8951,429,6521321,337
Ohio596$7,943,6941,023,4151211,436
Arizona585$7,396,895953,776731,489
Tennessee1,769$7,091,811917,5681171,480
Alabama1,144$6,488,905838,2021251,395
Illinois811$6,045,318779,737891,839
Georgia1,103$5,726,118739,4001491,296
Pennsylvania443$4,801,859619,2131022,299
Kansas411$4,410,159568,234110872
Virginia1,182$4,333,758559,7251211,629

Not listed: 6 billers with an armed-forces or unknown state code (AA, AE, XX, ZZ); they are in the national totals.

Not listed: 2 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-NJ1,701$24,743,7693,189,294172
Los Angeles-Long Beach-Anaheim, CA659$10,813,3721,392,865207
Burlington, NC47$8,951,2021,152,88271
Tampa-St. Petersburg-Clearwater, FL164$8,634,7681,112,687236
Dallas-Fort Worth-Arlington, TX614$7,607,074980,758232
Phoenix-Mesa-Chandler, AZ307$6,798,274876,59198
Chicago-Naperville-Elgin, IL-IN612$5,764,038743,57388
Miami-Fort Lauderdale-West Palm Beach, FL282$5,536,804713,203470
Houston-Pasadena-The Woodlands, TX406$4,383,209565,04178
Birmingham, AL305$4,244,139547,316125
Columbus, OH337$4,042,221520,699118
Austin-Round Rock-San Marcos, TX360$3,878,783499,82185
San Diego-Chula Vista-Carlsbad, CA64$3,823,997492,384707
Atlanta-Sandy Springs-Roswell, GA375$3,442,111443,451110
Kansas City, MO-KS183$3,424,282441,032134

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 96 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 85025 nationally

Clinical Laboratory accounts for 64% of payment for 85025 nationally in 2021, across 41 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory1,3503.9%$133,488,70964%17,197,22412,739
Hematology-Oncology2,3917.0%$21,827,09910%2,823,0421,181
Internal Medicine5,88917%$14,319,6916.9%1,849,617314
Family Practice9,06827%$13,927,0426.7%1,800,971199
Medical Oncology7152.1%$5,800,4552.8%750,3651,049
Nurse Practitioner6,10718%$4,790,8412.3%619,633101
Pathology1040.30%$3,026,7771.5%391,7063,766
Rheumatology8492.5%$2,888,5721.4%375,360442
Physician Assistant3,0809.0%$1,788,9100.86%231,38175
Nephrology5251.5%$967,1330.46%125,367239
Cardiology5401.6%$891,4450.43%115,016213
Endocrinology4041.2%$875,1580.42%112,982280
Hematology650.19%$736,4030.35%95,1351,464
Gastroenterology5341.6%$427,9860.21%55,868105
General Practice1720.50%$379,2120.18%49,049285

Not listed: 27 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 85025 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