HCPCS 86235
Laboratory test (ClaimLight category; the code descriptor is not shown)
Laboratory Work RVU per service none (2024 fee schedule; adds 0 work RVUs)
Trend
Medicare payment on the code
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.
Billers
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 | |
|---|---|---|---|---|---|---|---|
| 2024 | 751 | $28,666,680 | +7% | 1,639,127 | 240 | 6,842 | 0.00 |
| 2023 | 746 | $26,856,797 | +2% | 1,536,592 | 252 | 6,499 | 0.00 |
| 2022 | 761 | $26,428,877 | -5% | 1,499,504 | 238 | 7,011 | 0.00 |
| 2021 | 783 | $27,728,149 | +15% | 1,555,492 | 256 | 6,180 | 0.00 |
| 2020 | 756 | $24,048,861 | first year in data | 1,358,902 | 252 | 6,724 | 0.00 |
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 | |
|---|---|---|---|---|---|---|
| California | 71 | $4,904,943 | 279,603 | 987 | 13,713 | |
| New Jersey | 27 | $3,669,054 | 208,939 | 180 | 53,788 | |
| Texas | 62 | $3,263,289 | 186,431 | 451 | 15,929 | |
| Florida | 51 | $2,551,311 | 145,368 | 259 | 7,226 | |
| North Carolina | 28 | $2,535,445 | 144,431 | 168 | 1,144 | |
| New York | 48 | $1,642,137 | 93,518 | 541 | 7,942 | |
| Arizona | 20 | $1,262,202 | 72,041 | 148 | 31,351 | |
| Georgia | 17 | $1,079,180 | 61,531 | 319 | 11,840 | |
| Alabama | 23 | $977,261 | 55,763 | 273 | 2,526 | |
| Ohio | 38 | $828,606 | 50,581 | 189 | 2,671 | |
| Tennessee | 20 | $666,226 | 38,069 | 181 | 10,373 | |
| Illinois | 32 | $624,217 | 35,573 | 215 | 3,265 | |
| Kansas | 15 | $530,125 | 30,192 | 196 | 8,888 | |
| Pennsylvania | 16 | $457,314 | 26,087 | 681 | 6,304 | |
| Maryland | 45 | $401,446 | 22,974 | 238 | 1,306 |
Not listed: 24 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-NJ | 59 | $5,211,820 | 296,770 | 416 | |
| Los Angeles-Long Beach-Anaheim, CA | 40 | $2,557,200 | 145,830 | 998 | |
| Dallas-Fort Worth-Arlington, TX | 21 | $1,512,035 | 86,115 | 102 | |
| Phoenix-Mesa-Chandler, AZ | 18 | $1,256,131 | 71,693 | 148 | |
| Atlanta-Sandy Springs-Roswell, GA | 13 | $1,068,807 | 60,935 | 480 | |
| Chicago-Naperville-Elgin, IL-IN | 26 | $681,317 | 38,847 | 263 | |
| Columbus, OH | 18 | $637,421 | 36,304 | 128 | |
| Miami-Fort Lauderdale-West Palm Beach, FL | 20 | $544,326 | 30,984 | 151 | |
| Memphis, TN-MS-AR | 14 | $255,325 | 14,615 | 181 | |
| San Antonio-New Braunfels, TX | 13 | $242,967 | 14,068 | 1,038 | |
| Washington-Arlington-Alexandria, DC-VA-MD-WV | 36 | $235,844 | 13,536 | 218 | |
| Baltimore-Columbia-Towson, MD | 13 | $217,114 | 12,408 | 264 | |
| Milwaukee-Waukesha, WI | 12 | $210,708 | 12,165 | 105 | |
| Oklahoma City, OK | 12 | $169,948 | 9,902 | 237 | |
| North Port-Bradenton-Sarasota, FL | 13 | $95,026 | 5,431 | 353 |
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 16 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 86235 nationally
Clinical Laboratory accounts for 84% of payment for 86235 nationally in 2024, across 5 specialties on claims.
| observed | calculated | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|---|
| Clinical Laboratory | 236 | 31% | $24,164,162 | 84% | 1,381,116 | 5,852 |
| Rheumatology | 352 | 47% | $3,569,746 | 12% | 204,618 | 581 |
| Physician Assistant | 34 | 4.5% | $352,497 | 1.2% | 20,169 | 593 |
| Nurse Practitioner | 41 | 5.5% | $183,249 | 0.64% | 10,507 | 256 |
| Internal Medicine | 44 | 5.9% | $174,010 | 0.61% | 9,959 | 226 |
Not listed: 13 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 86235 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