HCPCS 85025

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

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

32,833
99th percentile among 6,405 codes billed · 2023
$198M
99th percentile among 6,405 codes billed · 2023
26.1M
100th percentile among 6,405 codes billed · 2023
89
84th percentile among 6,405 codes billed · 2023
1,348
89th percentile among 6,405 codes billed · 2023
-1.0%
Medicare payment on the code vs 2022; billers -1.6% · 2023

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
Florida1,931$22,270,7732,930,7132113,045
California1,214$20,850,0342,741,8481543,579
Texas2,913$19,094,1042,514,3271121,154
New Jersey746$18,023,8982,372,1161171,883
North Carolina1,920$14,259,0211,877,09380791
New York2,137$10,189,4101,341,0301231,284
Ohio608$7,107,561935,8771121,232
Arizona598$7,038,103926,262631,123
Alabama1,015$6,019,225794,7291111,283
Illinois849$5,600,277737,341851,788
Georgia1,030$5,337,770703,6081371,341
Tennessee1,865$5,109,151675,0521191,284
Virginia1,175$4,755,535626,9191031,626
Maryland636$4,202,089553,1991432,018
Kansas390$4,093,168538,316117839

Not listed: 4 billers with an armed-forces or unknown state code (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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,661$25,822,4593,397,726148
Los Angeles-Long Beach-Anaheim, CA683$10,147,8161,334,258153
Tampa-St. Petersburg-Clearwater, FL185$8,990,1141,182,374232
Burlington, NC47$8,724,3621,148,14683
Dallas-Fort Worth-Arlington, TX665$7,489,011985,866186
Phoenix-Mesa-Chandler, AZ347$6,622,932871,60267
Chicago-Naperville-Elgin, IL-IN621$5,371,202707,28881
Miami-Fort Lauderdale-West Palm Beach, FL281$5,111,960672,375323
Houston-Pasadena-The Woodlands, TX461$4,478,229589,19474
Birmingham, AL310$4,221,850556,82091
San Diego-Chula Vista-Carlsbad, CA59$4,100,445539,246501
Columbus, OH376$3,637,989478,71197
Austin-Round Rock-San Marcos, TX376$3,610,039474,97674
Atlanta-Sandy Springs-Roswell, GA353$3,385,597445,225106
Kansas City, MO-KS156$3,157,174415,010158

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 95 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 85025 nationally

Clinical Laboratory accounts for 67% of payment for 85025 nationally in 2023, across 44 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory1,3154.0%$131,999,31867%17,363,62113,204
Hematology-Oncology2,2756.9%$19,167,9239.7%2,530,9051,112
Internal Medicine5,20716%$12,290,6516.2%1,620,972311
Family Practice8,30825%$12,259,4956.2%1,618,263195
Medical Oncology6982.1%$5,106,9812.6%674,261966
Nurse Practitioner6,53820%$4,761,3982.4%628,95696
Pathology1300.40%$3,050,2391.5%402,5103,096
Rheumatology8112.5%$2,552,7441.3%338,331417
Physician Assistant3,32310%$1,998,3301.0%264,02179
Nephrology4431.3%$825,0380.42%109,113246
Endocrinology3791.2%$803,8740.41%105,915279
Cardiology4761.4%$682,2020.34%89,843189
Hematology640.19%$657,9010.33%86,7051,355
Gastroenterology3751.1%$421,2560.21%56,150150
General Practice1490.45%$305,4670.15%40,371271

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 2023.

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