HCPCS 85027

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

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

7,266
96th percentile among 6,405 codes billed · 2023
$21M
92nd percentile among 6,405 codes billed · 2023
3.3M
98th percentile among 6,405 codes billed · 2023
44
71st percentile among 6,405 codes billed · 2023
643
82nd percentile among 6,405 codes billed · 2023
+1.8%
Medicare payment on the code vs 2022; billers -2.6% · 2023

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
New Jersey81$2,368,818373,9231033,793
California213$2,125,032335,381802,920
North Carolina503$1,828,683288,89747427
Florida101$1,817,074286,7786212,396
Texas614$1,137,183179,63756322
Massachusetts440$967,920152,72940234
Ohio86$906,837143,283665,122
Arizona175$841,724132,905984,168
Virginia194$653,983103,35148556
Illinois189$641,637101,341611,017
Kansas81$601,78795,021914,485
New York254$598,15694,43954516
Minnesota1,113$512,03681,22931180
Washington352$457,52772,53830202
Tennessee382$456,78272,34753563

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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ128$2,849,069449,713194
Boston-Cambridge-Newton, MA-NH389$865,135136,50038
Los Angeles-Long Beach-Anaheim, CA84$817,572129,04479
Miami-Fort Lauderdale-West Palm Beach, FL20$507,72980,099169
Chicago-Naperville-Elgin, IL-IN125$480,87275,95647
San Diego-Chula Vista-Carlsbad, CA19$478,75875,545359
Dallas-Fort Worth-Arlington, TX216$452,97971,53260
Phoenix-Mesa-Chandler, AZ54$379,97760,048115
Atlanta-Sandy Springs-Roswell, GA34$363,81657,47555
Kansas City, MO-KS18$363,10557,28493
Minneapolis-St. Paul-Bloomington, MN-WI969$344,00354,68230
Birmingham, AL16$339,64553,67733
Seattle-Tacoma-Bellevue, WA210$339,01853,74931
Virginia Beach-Chesapeake-Norfolk, VA-NC60$329,80852,13568
Houston-Pasadena-The Woodlands, TX40$320,07550,52347

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 68 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 85027 nationally

Clinical Laboratory accounts for 77% of payment for 85027 nationally in 2023, across 22 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory5978.2%$15,837,26877%2,500,4414,188
Family Practice1,95327%$1,114,2245.4%176,74390
Internal Medicine1,23417%$966,5154.7%153,123124
Nurse Practitioner1,13916%$535,9282.6%84,79474
Hematology-Oncology4245.8%$524,0142.5%82,958196
Pathology861.2%$370,7491.8%58,623682
Physician Assistant6288.6%$306,3951.5%48,50277
Nephrology2102.9%$205,1361.00%32,537155
Medical Oncology1892.6%$150,3660.73%23,774126
Rheumatology911.3%$122,5260.59%19,462214
General Practice210.29%$82,2250.40%12,972618
Endocrinology981.3%$76,2050.37%12,060123
Interventional Cardiology680.94%$57,8080.28%9,153135
Cardiology1331.8%$56,9560.28%9,02968
Urology1121.5%$34,7070.17%5,49649

Not listed: 31 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 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