HCPCS 85610

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

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

9,567
97th percentile among 6,405 codes billed · 2023
$13M
90th percentile among 6,405 codes billed · 2023
3.0M
98th percentile among 6,405 codes billed · 2023
94
85th percentile among 6,405 codes billed · 2023
620
82nd percentile among 6,405 codes billed · 2023
-16.6%
Medicare payment on the code vs 2022; billers -17.8% · 2023

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 Jersey244$1,156,234275,44489472
California391$1,106,458263,6361162,348
Florida865$1,100,727262,346101482
New York517$684,939163,23463381
Illinois530$638,060152,148100686
Texas445$628,834150,00394506
North Carolina473$583,333139,14478356
Massachusetts237$497,370118,553118872
Pennsylvania282$464,048110,55793662
Ohio222$439,623104,821105726
Wisconsin330$424,621101,768121805
Minnesota523$411,83298,21591427
Arizona202$402,18295,96097621
Tennessee407$298,64971,37499546
Kansas173$259,00461,75395956

Not listed: 1 billers with an armed-forces or unknown state code (AE); they are in the national totals.

Not listed: 4 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-NJ547$1,697,026404,27172
Chicago-Naperville-Elgin, IL-IN391$523,376124,811100
Los Angeles-Long Beach-Anaheim, CA167$471,150112,234117
Boston-Cambridge-Newton, MA-NH169$393,98093,908120
Phoenix-Mesa-Chandler, AZ140$373,27289,051118
Tampa-St. Petersburg-Clearwater, FL100$333,17879,36287
Miami-Fort Lauderdale-West Palm Beach, FL69$243,66958,010102
Dallas-Fort Worth-Arlington, TX112$241,04657,496131
Milwaukee-Waukesha, WI103$220,08952,937118
Minneapolis-St. Paul-Bloomington, MN-WI397$189,45045,22584
San Diego-Chula Vista-Carlsbad, CA21$181,02843,116277
Atlanta-Sandy Springs-Roswell, GA169$158,92837,91984
Houston-Pasadena-The Woodlands, TX64$155,06936,94973
Kansas City, MO-KS83$150,20835,79268
Cincinnati, OH-KY-IN34$147,68635,164119

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 84 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 85610 nationally

Clinical Laboratory accounts for 58% of payment for 85610 nationally in 2023, across 22 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory7307.6%$7,234,92658%1,724,7802,363
Cardiology2,08422%$1,489,34412%355,556171
Family Practice2,15623%$1,090,5358.7%260,526121
Internal Medicine1,73318%$917,5707.3%219,226127
Nurse Practitioner8699.1%$627,8415.0%150,056173
Interventional Cardiology5055.3%$327,1032.6%78,038155
Pathology660.69%$269,8402.2%64,601979
Hematology-Oncology4084.3%$154,1151.2%36,86390
Physician Assistant3093.2%$134,5091.1%32,192104
Clinical Cardiac Electrophysiology2092.2%$113,2900.90%27,047129
Medical Oncology1021.1%$36,2610.29%8,67985
Gastroenterology630.66%$16,4650.13%4,03364
General Practice260.27%$14,4990.12%3,456133
Emergency Medicine420.44%$13,5970.11%3,25477
Advanced Heart Failure and Transplant Cardiology270.28%$11,8970.09%2,835105

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 2023.

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