HCPCS 86769

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

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

698
83rd percentile among 6,326 codes billed · 2022
$28M
94th percentile among 6,326 codes billed · 2022
665K
94th percentile among 6,326 codes billed · 2022
65
80th percentile among 6,326 codes billed · 2022
3,582
95th percentile among 6,326 codes billed · 2022
-44.4%
Medicare payment on the code vs 2021; billers -52.9% · 2022

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
New Jersey45$7,908,155189,7697737,831
New York135$4,384,572105,330632,259
California83$3,467,81483,3701333,858
Florida92$3,228,81877,476521,360
Texas52$1,798,09443,129944,421
North Carolina29$1,775,78642,621402,544
Ohio12$614,35214,7261206,460
Arizona12$604,92314,483966,403
Tennessee23$560,12513,467373,579
Alabama23$473,41311,337391,068
Georgia15$372,1558,939602,529
Illinois16$321,7037,722381,855
Maryland11$204,2094,914752,108
Pennsylvania15$174,7634,19596797
Michigan16$110,6062,70737840

Not listed: 32 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-NJ164$11,921,995286,19366
Los Angeles-Long Beach-Anaheim, CA58$1,807,98443,418126
Miami-Fort Lauderdale-West Palm Beach, FL39$1,287,50330,88892
Dallas-Fort Worth-Arlington, TX22$699,78716,774250
Chicago-Naperville-Elgin, IL-IN16$336,2938,07338
Greensboro-High Point, NC18$227,6705,48359
Detroit-Warren-Dearborn, MI13$106,2252,59944

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 7 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 86769 nationally

Clinical Laboratory accounts for 90% of payment for 86769 nationally in 2022, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory29042%$24,825,18190%595,6092,054
Internal Medicine17826%$1,327,5694.8%32,013180
Rheumatology284.0%$516,1651.9%12,473445
Family Practice7811%$376,8971.4%9,081116
Endocrinology111.6%$177,0220.64%4,345395
Physician Assistant162.3%$87,4590.32%2,109132
Hematology-Oncology213.0%$64,8530.23%1,56575
Nurse Practitioner243.4%$42,9510.15%1,03643

Not listed: 16 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 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