HCPCS 85610

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

Laboratory Work RVU per service none (2022 fee schedule; adds 0 work RVUs)

11,637
97th percentile among 6,326 codes billed · 2022
$15M
91st percentile among 6,326 codes billed · 2022
3.6M
98th percentile among 6,326 codes billed · 2022
99
86th percentile among 6,326 codes billed · 2022
605
83rd percentile among 6,326 codes billed · 2022
-19.4%
Medicare payment on the code vs 2021; billers -17.9% · 2022

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
Florida1,052$1,347,336318,178107522
New Jersey273$1,299,352306,87488538
California450$1,206,657285,0411301,951
New York584$819,980193,76573379
Illinois645$792,997187,535111647
Texas531$733,672173,42695525
North Carolina606$692,102163,62092379
Massachusetts302$600,588141,823125551
Pennsylvania333$562,600132,95687902
Ohio291$543,065128,333102602
Wisconsin397$534,345126,853118586
Minnesota608$516,897122,26399427
Arizona240$452,722107,027104739
Tennessee499$403,72295,74296576
Kansas202$331,62078,34594999

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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ609$1,926,396454,96472
Chicago-Naperville-Elgin, IL-IN462$630,380149,082109
Los Angeles-Long Beach-Anaheim, CA181$515,347121,720123
Boston-Cambridge-Newton, MA-NH220$483,220114,054126
Phoenix-Mesa-Chandler, AZ148$408,35796,531137
Tampa-St. Petersburg-Clearwater, FL132$376,42688,81092
Miami-Fort Lauderdale-West Palm Beach, FL86$295,73969,776122
Milwaukee-Waukesha, WI130$271,58064,63292
Dallas-Fort Worth-Arlington, TX140$269,22063,613119
Minneapolis-St. Paul-Bloomington, MN-WI473$247,99358,72392
Kansas City, MO-KS98$203,41148,03379
Cincinnati, OH-KY-IN52$192,75145,486101
San Diego-Chula Vista-Carlsbad, CA25$191,05145,134280
Atlanta-Sandy Springs-Roswell, GA196$189,72644,89589
Allentown-Bethlehem-Easton, PA-NJ23$166,96739,43595

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 88 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2022.

Specialties billing 85610 nationally

Clinical Laboratory accounts for 54% of payment for 85610 nationally in 2022, across 23 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory7646.6%$8,184,59054%1,933,3242,531
Cardiology2,39421%$1,870,77712%442,691185
Family Practice2,86025%$1,496,37010.0%354,358124
Internal Medicine2,31820%$1,359,9939.1%322,262139
Nurse Practitioner1,0729.2%$772,1945.1%183,002171
Interventional Cardiology5384.6%$391,2092.6%92,560172
Pathology550.47%$266,1701.8%63,2211,149
Hematology-Oncology4644.0%$189,8811.3%45,01697
Physician Assistant3653.1%$160,4531.1%38,005104
Clinical Cardiac Electrophysiology2442.1%$138,3900.92%32,721134
Medical Oncology1150.99%$43,5070.29%10,34490
General Practice440.38%$20,5590.14%4,862111
Advanced Heart Failure and Transplant Cardiology320.27%$17,0070.11%4,018126
Emergency Medicine430.37%$15,8600.11%3,76388
Gastroenterology820.70%$15,1660.10%3,65645

Not listed: 32 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 2022.

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