HCPCS 85027

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

Laboratory Work RVU per service none (2020 fee schedule; adds 0 work RVUs)

7,527
96th percentile among 6,116 codes billed · 2020
$20M
92nd percentile among 6,116 codes billed · 2020
3.1M
98th percentile among 6,116 codes billed · 2020
46
74th percentile among 6,116 codes billed · 2020
653
84th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$10M$20M2020: $20M paid20202021: $21M paid20212022: $20M paid20222023: $21M paid20232024: $21M paid2024$21M$0$10M$20M2020: $20M paid20202021: $21M paid20212022: $20M paid20222023: $21M paid20232024: $21M paid2024$21M$0$10M$20M2020: $20M paid20202021: $21M paid20212022: $20M paid20222023: $21M paid20232024: $21M paid2024$21M$0$10M$20M2020: $20M paid20202021: $21M paid20212022: $20M paid20222023: $21M paid20232024: $21M paid2024$21M

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

Billers

05,0002020: 7,527 providers20202021: 7,544 providers20212022: 7,459 providers20222023: 7,266 providers20232024: 7,224 providers20247,22405,0002020: 7,527 providers20202021: 7,544 providers20212022: 7,459 providers20222023: 7,266 providers20232024: 7,224 providers20247,22405,0002020: 7,527 providers20202021: 7,544 providers20212022: 7,459 providers20222023: 7,266 providers20232024: 7,224 providers20247,22405,0002020: 7,527 providers20202021: 7,544 providers20212022: 7,459 providers20222023: 7,266 providers20232024: 7,224 providers20247,224

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
20247,224$20,807,456+1%3,287,573446400.00
20237,266$20,606,408+2%3,255,922446430.00
20227,459$20,240,642-3%3,173,277446010.00
20217,544$20,842,256+4%3,228,115456220.00
20207,527$20,098,567first year in data3,132,806466530.00

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
California191$1,927,135299,940812,025
Florida126$1,913,270298,198533,678
New Jersey39$1,898,763295,34419620,590
North Carolina521$1,569,767244,53950495
Texas665$1,330,333207,37366384
Ohio101$1,046,401162,953595,000
Massachusetts456$992,786154,49735252
Tennessee388$787,438123,05586617
Pennsylvania98$702,822109,391426,039
Kansas81$673,327104,8911244,090
Illinois209$562,78487,65853925
Washington362$502,75778,59232392
New York225$491,78576,55844728
Minnesota1,023$459,53072,09031198
Georgia152$457,41471,40544581

Not listed: 1 billers with an armed-forces or unknown state code (ZZ); they are in the national totals.

Not listed: 5 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ87$2,213,024344,229227
Boston-Cambridge-Newton, MA-NH408$910,270141,60836
Los Angeles-Long Beach-Anaheim, CA69$760,778118,45971
Miami-Fort Lauderdale-West Palm Beach, FL18$568,77188,598134
Dallas-Fort Worth-Arlington, TX205$513,92980,08668
San Diego-Chula Vista-Carlsbad, CA18$436,40367,925360
Chicago-Naperville-Elgin, IL-IN149$408,16963,55949
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD28$375,78058,48647
Kansas City, MO-KS19$370,80557,71176
Seattle-Tacoma-Bellevue, WA226$366,81857,35032
Atlanta-Sandy Springs-Roswell, GA43$363,16856,62555
Columbus, OH16$357,92055,67823
Birmingham, AL14$337,70052,58752
Phoenix-Mesa-Chandler, AZ27$334,88552,229160
Houston-Pasadena-The Woodlands, TX36$320,40649,83567

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 73 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing 85027 nationally

Clinical Laboratory accounts for 75% of payment for 85027 nationally in 2020, across 26 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory5847.8%$15,025,58775%2,339,5664,006
Internal Medicine1,50220%$1,292,0556.4%201,896134
Family Practice2,14729%$1,277,9966.4%199,93393
Hematology-Oncology4435.9%$651,0323.2%101,658229
Pathology700.93%$396,6462.0%62,117887
Nurse Practitioner91212%$284,0801.4%44,39849
Nephrology2353.1%$220,0161.1%34,483147
Medical Oncology2212.9%$196,4450.98%30,670139
Rheumatology1331.8%$185,8270.92%29,191219
Physician Assistant5297.0%$170,9960.85%26,72251
Cardiology1181.6%$84,8460.42%13,251112
Interventional Cardiology730.97%$57,5840.29%8,988123
Endocrinology751.00%$56,9390.28%8,903119
Gastroenterology981.3%$31,2140.16%4,87850
General Practice270.36%$29,8890.15%4,660173

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 2020.

Top billers of 85027 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