HCPCS 85610

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

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

17,669
98th percentile among 6,116 codes billed · 2020
$23M
93rd percentile among 6,116 codes billed · 2020
5.4M
99th percentile among 6,116 codes billed · 2020
105
88th percentile among 6,116 codes billed · 2020
593
83rd percentile among 6,116 codes billed · 2020

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
Florida1,602$2,174,481512,138117648
California652$1,676,554394,1301371,539
New Jersey404$1,577,284370,57693476
New York911$1,421,145334,06791436
Illinois889$1,228,158288,963117666
Texas792$1,107,565260,668101649
Pennsylvania417$1,073,170252,2581061,316
North Carolina938$1,023,643240,800107418
Massachusetts457$980,041230,324139501
Ohio476$929,988218,90897523
Wisconsin528$841,747198,651131723
Minnesota970$739,099174,31491379
Tennessee749$616,919145,60198545
Arizona329$608,586143,448117874
Georgia568$516,071121,594113559

Not listed: 1 billers with an armed-forces or unknown state code (XX); 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-NJ895$2,610,790613,40286
Chicago-Naperville-Elgin, IL-IN635$981,258230,881112
Boston-Cambridge-Newton, MA-NH349$802,955188,649134
Los Angeles-Long Beach-Anaheim, CA238$663,043155,828127
Tampa-St. Petersburg-Clearwater, FL200$537,383126,397112
Phoenix-Mesa-Chandler, AZ203$532,801125,601145
Miami-Fort Lauderdale-West Palm Beach, FL175$513,072120,682126
Cincinnati, OH-KY-IN86$431,706101,492106
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD141$410,70996,51699
Milwaukee-Waukesha, WI145$402,73295,167113
Minneapolis-St. Paul-Bloomington, MN-WI778$399,59094,14385
Burlington, NC12$384,81490,442109
Dallas-Fort Worth-Arlington, TX198$356,88583,979132
Atlanta-Sandy Springs-Roswell, GA262$301,75671,006112
Kansas City, MO-KS99$249,19258,551108

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 94 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 85610 nationally

Clinical Laboratory accounts for 50% of payment for 85610 nationally in 2020, across 28 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory8494.8%$11,604,86050%2,727,6103,213
Cardiology3,29019%$3,052,29913%719,110219
Family Practice4,88528%$2,670,92012%629,382129
Internal Medicine4,04023%$2,594,19011%611,516151
Nurse Practitioner1,4248.1%$1,012,2774.4%238,485167
Interventional Cardiology6933.9%$550,8992.4%129,746187
Pathology630.36%$425,0911.8%101,0411,604
Hematology-Oncology6483.7%$306,0941.3%72,242111
Physician Assistant5673.2%$271,7541.2%63,992113
Clinical Cardiac Electrophysiology2861.6%$205,0500.89%48,306169
Medical Oncology1750.99%$82,2200.36%19,436111
General Practice830.47%$48,7990.21%11,512139
Advanced Heart Failure and Transplant Cardiology440.25%$32,0970.14%7,556172
Geriatric Medicine460.26%$24,1370.10%5,686124
Gastroenterology1500.85%$23,5630.10%5,56137

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 2020.

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