HCPCS 85027

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

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

7,544
96th percentile among 6,253 codes billed · 2021
$21M
92nd percentile among 6,253 codes billed · 2021
3.2M
98th percentile among 6,253 codes billed · 2021
45
72nd percentile among 6,253 codes billed · 2021
622
83rd percentile among 6,253 codes billed · 2021
+3.7%
Medicare payment on the code vs 2020; billers +0.2% · 2021

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
California184$2,125,369328,705962,381
New Jersey54$2,079,521321,537626,884
Florida129$1,921,379297,349413,084
North Carolina527$1,649,647255,32247496
Texas653$1,333,559206,51867408
Massachusetts491$1,105,707170,99841289
Ohio99$1,043,880161,503555,316
Tennessee376$817,494126,95975652
Kansas83$733,072113,4861574,198
Pennsylvania85$616,04895,290446,313
Illinois213$609,76694,46852913
Minnesota1,090$516,70480,40232198
Washington363$490,24776,19930257
New York255$479,73474,23248523
Georgia134$475,32673,90353672

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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ114$2,429,764375,70176
Boston-Cambridge-Newton, MA-NH413$1,015,635157,05144
Los Angeles-Long Beach-Anaheim, CA66$850,315131,56481
Dallas-Fort Worth-Arlington, TX203$527,31181,65572
Miami-Fort Lauderdale-West Palm Beach, FL18$519,60180,339136
San Diego-Chula Vista-Carlsbad, CA20$454,86470,315332
Chicago-Naperville-Elgin, IL-IN140$449,71469,68150
Kansas City, MO-KS17$424,58565,67161
Atlanta-Sandy Springs-Roswell, GA43$385,61559,89562
Columbus, OH18$379,82358,73426
Seattle-Tacoma-Bellevue, WA227$378,64458,84626
Minneapolis-St. Paul-Bloomington, MN-WI936$353,73055,11030
Nashville-Davidson--Murfreesboro--Franklin, TN93$349,60454,19166
Phoenix-Mesa-Chandler, AZ46$334,43351,78448
Houston-Pasadena-The Woodlands, TX44$328,38650,79259

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 69 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 85027 nationally

Clinical Laboratory accounts for 76% of payment for 85027 nationally in 2021, across 23 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory5787.7%$15,898,39676%2,459,7524,256
Internal Medicine1,43119%$1,252,7266.0%194,676136
Family Practice2,13228%$1,230,2455.9%191,19290
Hematology-Oncology4496.0%$620,3453.0%96,379215
Pathology660.87%$377,2741.8%58,550887
Nurse Practitioner98513%$322,7061.5%50,11951
Nephrology2152.8%$208,9411.0%32,486151
Physician Assistant5797.7%$194,5560.93%30,23452
Rheumatology1251.7%$182,6680.88%28,513228
Medical Oncology2152.8%$169,6930.81%26,331122
Cardiology1341.8%$79,7190.38%12,39593
Endocrinology821.1%$60,3190.29%9,365114
Interventional Cardiology730.97%$58,1640.28%9,023124
Gastroenterology931.2%$33,2590.16%5,26257
Urology1111.5%$32,0070.15%4,98845

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 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