HCPCS 86769

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

Laboratory Work RVU per service none (2024 fee schedule; adds 0 work RVUs)

161
72nd percentile among 6,471 codes billed · 2024
$4.3M
82nd percentile among 6,471 codes billed · 2024
105K
86th percentile among 6,471 codes billed · 2024
124
86th percentile among 6,471 codes billed · 2024
3,555
94th percentile among 6,471 codes billed · 2024
-55.2%
Medicare payment on the code vs 2023; billers -43.7% · 2024

Trend

Medicare payment on the code

$0$20M$40M2020: $50M paid20202021: $50M paid20212022: $28M paid20222023: $9.6M paid20232024: $4.3M paid2024$4.3M$0$20M$40M2020: $50M paid20202021: $50M paid20212022: $28M paid20222023: $9.6M paid20232024: $4.3M paid2024$4.3M$0$20M$40M2020: $50M paid20202021: $50M paid20212022: $28M paid20222023: $9.6M paid20232024: $4.3M paid2024$4.3M$0$20M$40M2020: $50M paid20202021: $50M paid20212022: $28M paid20222023: $9.6M paid20232024: $4.3M paid2024$4.3M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

01,0002,0002020: 2,011 providers20202021: 1,481 providers20212022: 698 providers20222023: 286 providers20232024: 161 providers202416101,0002,0002020: 2,011 providers20202021: 1,481 providers20212022: 698 providers20222023: 286 providers20232024: 161 providers202416101,0002,0002020: 2,011 providers20202021: 1,481 providers20212022: 698 providers20222023: 286 providers20232024: 161 providers202416101,0002,0002020: 2,011 providers20202021: 1,481 providers20212022: 698 providers20222023: 286 providers20232024: 161 providers2024161

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
2024161$4,294,205-55%104,5771243,5550.00
2023286$9,586,898-65%232,5961183,5230.00
2022698$27,712,263-44%665,309653,5820.00
20211,481$49,817,552+0%1,184,606381,5970.00
20202,011$49,643,748first year in data1,182,78934822

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
California28$1,024,56825,2341683,564
New Jersey11$843,14820,4334056,080
Florida17$613,51614,864943,762
New York26$584,11814,2261502,304
Texas19$282,0366,845195966

Not listed: 27 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-NJ34$1,414,14334,339223
Los Angeles-Long Beach-Anaheim, CA19$490,25012,245146
Dallas-Fort Worth-Arlington, TX12$112,9572,740120

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 3 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 86769 nationally

Clinical Laboratory accounts for 80% of payment for 86769 nationally in 2024, across 2 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory10163%$3,440,02880%83,778829
Internal Medicine2918%$476,55411%11,582399

Not listed: 10 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 86769 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