HCPCS 85025

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

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

33,355
99th percentile among 6,326 codes billed · 2022
$201M
99th percentile among 6,326 codes billed · 2022
26.2M
100th percentile among 6,326 codes billed · 2022
90
85th percentile among 6,326 codes billed · 2022
1,365
90th percentile among 6,326 codes billed · 2022
-3.6%
Medicare payment on the code vs 2021; billers -2.5% · 2022

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%26,138,972891,3480.00
202233,355$200,531,883-4%26,201,444901,3650.00
202134,218$208,012,404+4%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
Florida1,934$22,159,6342,891,8142253,124
California1,209$20,520,2972,676,8921793,477
Texas2,821$19,445,2622,539,9841291,141
New Jersey719$17,395,3352,271,9441522,074
North Carolina1,997$13,198,2601,723,41779870
New York2,190$10,337,4351,350,0291141,246
Arizona600$7,569,542988,617671,210
Ohio615$7,270,186949,5531161,191
Tennessee1,806$6,754,232884,9271091,368
Alabama1,060$6,070,018794,0101151,207
Illinois797$5,714,343746,724901,795
Georgia1,058$5,301,805693,4491381,246
Virginia1,160$4,669,302610,6311101,677
Kansas406$4,394,600573,530107811
Maryland634$4,290,622560,6661432,153

Not listed: 4 billers with an armed-forces or unknown state code (AA, AE, XX); 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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,703$25,099,6373,277,500157
Los Angeles-Long Beach-Anaheim, CA686$10,477,2411,366,606163
Burlington, NC50$8,738,6901,140,32666
Tampa-St. Petersburg-Clearwater, FL160$8,692,7901,133,930266
Dallas-Fort Worth-Arlington, TX629$7,528,155983,039212
Phoenix-Mesa-Chandler, AZ354$6,623,354864,79068
Chicago-Naperville-Elgin, IL-IN596$5,549,343725,32779
Miami-Fort Lauderdale-West Palm Beach, FL281$5,225,942681,444367
Houston-Pasadena-The Woodlands, TX434$4,378,599571,31080
Birmingham, AL305$4,181,378546,133116
San Diego-Chula Vista-Carlsbad, CA59$3,902,704509,085741
Columbus, OH353$3,745,648488,814104
Austin-Round Rock-San Marcos, TX372$3,745,056488,80775
Kansas City, MO-KS181$3,480,458454,059136
Atlanta-Sandy Springs-Roswell, GA361$3,347,123436,760105

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 2022.

Specialties billing 85025 nationally

Clinical Laboratory accounts for 65% of payment for 85025 nationally in 2022, across 44 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory1,3143.9%$130,781,23565%17,065,16112,987
Hematology-Oncology2,3847.1%$20,242,45510%2,651,8421,112
Internal Medicine5,53517%$13,140,4426.6%1,719,006311
Family Practice8,70226%$12,821,2266.4%1,679,465193
Medical Oncology7012.1%$5,339,0652.7%699,162997
Nurse Practitioner6,26719%$4,891,2212.4%640,880102
Pathology1110.33%$2,963,3431.5%388,0043,496
Rheumatology8502.5%$2,686,2011.3%353,461416
Physician Assistant3,1489.4%$2,031,3491.0%266,21785
Nephrology4741.4%$872,2000.43%114,428241
Endocrinology3981.2%$864,8570.43%113,047284
Cardiology4981.5%$776,3570.39%101,459204
Hematology650.19%$655,9070.33%85,7671,319
General Practice1530.46%$397,5280.20%52,052340
Gastroenterology4201.3%$372,3390.19%49,281117

Not listed: 24 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 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