HCPCS 85610

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

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

14,168
98th percentile among 6,253 codes billed · 2021
$19M
91st percentile among 6,253 codes billed · 2021
4.4M
98th percentile among 6,253 codes billed · 2021
104
87th percentile among 6,253 codes billed · 2021
614
83rd percentile among 6,253 codes billed · 2021
-19.2%
Medicare payment on the code vs 2020; billers -19.8% · 2021

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
Florida1,291$1,699,074396,792115595
California528$1,424,635332,3651281,766
New Jersey305$1,392,621324,756102520
New York702$1,068,576249,31785438
Illinois771$1,009,790235,788116751
Texas646$873,555203,968100538
North Carolina747$849,850198,345102390
Pennsylvania381$807,457188,37398939
Massachusetts350$784,589183,009138552
Ohio355$734,555171,431106519
Wisconsin457$699,599163,881135751
Minnesota744$627,426146,743100456
Arizona286$516,632120,730110762
Tennessee626$506,030118,56693532
Kansas219$411,16895,9011091,208

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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ708$2,216,707516,96985
Chicago-Naperville-Elgin, IL-IN558$799,835186,746109
Boston-Cambridge-Newton, MA-NH250$642,713149,843145
Los Angeles-Long Beach-Anaheim, CA204$577,972134,852106
Phoenix-Mesa-Chandler, AZ185$463,835108,342132
Tampa-St. Petersburg-Clearwater, FL166$441,466103,010100
Miami-Fort Lauderdale-West Palm Beach, FL122$381,86389,034130
Milwaukee-Waukesha, WI134$336,99279,106111
Minneapolis-St. Paul-Bloomington, MN-WI585$322,40475,43793
Dallas-Fort Worth-Arlington, TX175$309,80572,314107
Cincinnati, OH-KY-IN63$308,33271,884102
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD102$250,59758,433111
Atlanta-Sandy Springs-Roswell, GA218$242,01356,48297
Kansas City, MO-KS91$230,36853,71862
San Diego-Chula Vista-Carlsbad, CA33$214,32249,980164

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 87 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 85610 nationally

Clinical Laboratory accounts for 52% of payment for 85610 nationally in 2021, across 24 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory8075.7%$9,686,72552%2,259,5962,800
Cardiology2,75319%$2,435,46513%569,309207
Family Practice3,77727%$2,047,48611%478,724127
Internal Medicine3,01221%$1,910,93710%447,169148
Nurse Practitioner1,1778.3%$881,2034.7%206,151175
Interventional Cardiology6054.3%$467,2152.5%109,268181
Pathology530.37%$297,3321.6%70,0141,321
Hematology-Oncology5634.0%$250,7071.3%58,709104
Physician Assistant4443.1%$212,2961.1%49,638112
Clinical Cardiac Electrophysiology2621.8%$176,7560.95%41,320158
Medical Oncology1390.98%$56,8940.31%13,36096
General Practice600.42%$32,1830.17%7,536126
Advanced Heart Failure and Transplant Cardiology350.25%$23,0330.12%5,381154
Gastroenterology1110.78%$20,5050.11%4,89044
Vascular Surgery380.27%$16,3730.09%3,830101

Not listed: 36 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 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