HCPCS 85610

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

Laboratory Work RVU per service none (2024 fee schedule; adds 0 work RVUs)

7,719
96th percentile among 6,471 codes billed · 2024
$11M
88th percentile among 6,471 codes billed · 2024
2.5M
98th percentile among 6,471 codes billed · 2024
91
83rd percentile among 6,471 codes billed · 2024
639
81st percentile among 6,471 codes billed · 2024
-15.4%
Medicare payment on the code vs 2023; billers -19.3% · 2024

Trend

Medicare payment on the code

$0$10M$20M2020: $23M paid20202021: $19M paid20212022: $15M paid20222023: $13M paid20232024: $11M paid2024$11M$0$10M$20M2020: $23M paid20202021: $19M paid20212022: $15M paid20222023: $13M paid20232024: $11M paid2024$11M$0$10M$20M2020: $23M paid20202021: $19M paid20212022: $15M paid20222023: $13M paid20232024: $11M paid2024$11M$0$10M$20M2020: $23M paid20202021: $19M paid20212022: $15M paid20222023: $13M paid20232024: $11M paid2024$11M

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

Billers

010K2020: 18K providers20202021: 14K providers20212022: 12K providers20222023: 9,567 providers20232024: 7,719 providers20247,719010K2020: 18K providers20202021: 14K providers20212022: 12K providers20222023: 9,567 providers20232024: 7,719 providers20247,719010K2020: 18K providers20202021: 14K providers20212022: 12K providers20222023: 9,567 providers20232024: 7,719 providers20247,719010K2020: 18K providers20202021: 14K providers20212022: 12K providers20222023: 9,567 providers20232024: 7,719 providers20247,719

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
20247,719$10,605,081-15%2,529,787916390.00
20239,567$12,532,287-17%2,990,345946200.00
202211,637$15,027,121-19%3,553,942996050.00
202114,168$18,647,982-19%4,355,9611046140.00
202017,669$23,083,019first year in data5,433,3151055930.00

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 Jersey172$1,124,443267,838902,643
California347$999,294238,0641182,371
Florida644$890,290212,11896460
New York418$555,213132,35563372
Illinois463$553,597132,087103813
Texas375$548,038130,61090486
North Carolina353$456,046108,72974287
Massachusetts157$408,53197,3931182,556
Pennsylvania248$388,47292,55292861
Ohio167$368,03787,79299689
Wisconsin277$355,18385,071117777
Minnesota420$343,92182,00578456
Arizona161$330,95078,91698507
Tennessee352$266,10263,70087496
Kansas157$226,93354,083100961

Not listed: 7 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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ395$1,563,802372,50371
Chicago-Naperville-Elgin, IL-IN356$457,037109,01997
Los Angeles-Long Beach-Anaheim, CA158$430,554102,56996
Boston-Cambridge-Newton, MA-NH115$337,09080,384112
Phoenix-Mesa-Chandler, AZ121$310,59174,059126
Tampa-St. Petersburg-Clearwater, FL84$303,26072,22378
Dallas-Fort Worth-Arlington, TX102$218,46252,057121
Miami-Fort Lauderdale-West Palm Beach, FL52$198,62947,20589
San Diego-Chula Vista-Carlsbad, CA18$191,78545,687395
Milwaukee-Waukesha, WI91$186,36544,788112
Minneapolis-St. Paul-Bloomington, MN-WI321$148,19335,36972
Houston-Pasadena-The Woodlands, TX55$145,17934,57364
Atlanta-Sandy Springs-Roswell, GA152$134,15232,04380
Kansas City, MO-KS60$125,77429,94789
Allentown-Bethlehem-Easton, PA-NJ16$123,61829,461155

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 77 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2024.

Specialties billing 85610 nationally

Clinical Laboratory accounts for 62% of payment for 85610 nationally in 2024, across 19 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory6919.0%$6,529,61762%1,556,4872,253
Cardiology1,75523%$1,141,96211%272,653155
Family Practice1,61221%$805,2727.6%192,252119
Internal Medicine1,24916%$642,3286.1%153,371123
Nurse Practitioner7089.2%$495,1954.7%118,381167
Interventional Cardiology4445.8%$267,4202.5%63,761144
Pathology740.96%$256,6982.4%61,327829
Hematology-Oncology3484.5%$128,1301.2%30,62388
Physician Assistant2393.1%$116,4831.1%27,887117
Clinical Cardiac Electrophysiology1832.4%$89,5720.84%21,369117
Medical Oncology851.1%$29,4870.28%7,04483
Gastroenterology600.78%$15,4360.15%3,74962
Emergency Medicine320.41%$11,2950.11%2,69584
Hospitalist160.21%$11,1250.10%2,655166
General Practice180.23%$10,5460.10%2,511140

Not listed: 33 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 2024.

Top billers of 85610 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