HCPCS 87086

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

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

4,506
95th percentile among 6,471 codes billed · 2024
$35M
94th percentile among 6,471 codes billed · 2024
4.4M
98th percentile among 6,471 codes billed · 2024
30
57th percentile among 6,471 codes billed · 2024
1,478
89th percentile among 6,471 codes billed · 2024
-1.2%
Medicare payment on the code vs 2023; billers -11.2% · 2024

Trend

Medicare payment on the code

$0$20M2020: $34M paid20202021: $35M paid20212022: $34M paid20222023: $35M paid20232024: $35M paid2024$35M$0$20M2020: $34M paid20202021: $35M paid20212022: $34M paid20222023: $35M paid20232024: $35M paid2024$35M$0$20M2020: $34M paid20202021: $35M paid20212022: $34M paid20222023: $35M paid20232024: $35M paid2024$35M$0$20M2020: $34M paid20202021: $35M paid20212022: $34M paid20222023: $35M paid20232024: $35M paid2024$35M

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

Billers

02,0004,0002020: 5,092 providers20202021: 4,801 providers20212022: 4,851 providers20222023: 5,074 providers20232024: 4,506 providers20244,50602,0004,0002020: 5,092 providers20202021: 4,801 providers20212022: 4,851 providers20222023: 5,074 providers20232024: 4,506 providers20244,50602,0004,0002020: 5,092 providers20202021: 4,801 providers20212022: 4,851 providers20222023: 5,074 providers20232024: 4,506 providers20244,50602,0004,0002020: 5,092 providers20202021: 4,801 providers20212022: 4,851 providers20222023: 5,074 providers20232024: 4,506 providers20244,506

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
20244,506$34,813,358-1%4,406,190301,4780.00
20235,074$35,223,975+2%4,458,847321,1250.00
20224,851$34,475,594-1%4,331,371311,1770.00
20214,801$34,974,603+3%4,338,655321,2950.00
20205,092$33,809,775first year in data4,221,535311,0350.00

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 Jersey278$4,156,823526,03030422
Florida86$3,906,090493,9148919,336
California120$3,791,313480,01126111,993
Texas414$3,380,328427,74231649
North Carolina228$2,431,030307,52139172
New York639$1,777,533224,88628435
Arizona151$1,403,784177,74440627
Ohio56$1,339,397169,5136812,267
Illinois60$1,193,910151,060598,255
Tennessee68$1,056,908133,871481,593
Alabama72$1,023,407129,535652,699
Massachusetts361$968,519122,47124121
Georgia68$889,161112,48542393
Virginia273$798,297101,11434310
Kansas13$763,05596,49337833,657

Not listed: 15 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-NJ504$5,709,274722,36131
Tampa-St. Petersburg-Clearwater, FL13$2,230,122281,982614
Los Angeles-Long Beach-Anaheim, CA87$1,787,155226,032127
Dallas-Fort Worth-Arlington, TX163$1,614,542204,32237
Phoenix-Mesa-Chandler, AZ25$1,350,071170,944448
Miami-Fort Lauderdale-West Palm Beach, FL30$1,239,822156,726405
Chicago-Naperville-Elgin, IL-IN41$1,187,825150,258228
Birmingham, AL56$931,028117,81461
Houston-Pasadena-The Woodlands, TX12$915,993115,915495
Boston-Cambridge-Newton, MA-NH371$906,500114,62523
Atlanta-Sandy Springs-Roswell, GA21$853,570107,93048
Austin-Round Rock-San Marcos, TX117$727,80292,04719
Nashville-Davidson--Murfreesboro--Franklin, TN33$595,63575,46260
Seattle-Tacoma-Bellevue, WA100$547,93469,37023
Baltimore-Columbia-Towson, MD18$391,60349,53745

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 39 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 87086 nationally

Clinical Laboratory accounts for 92% of payment for 87086 nationally in 2024, across 10 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory55812%$32,026,15092%4,052,4667,262
Pathology370.82%$979,1742.8%124,2793,359
Urology59913%$758,9252.2%96,239161
Family Practice98022%$322,6990.93%40,99442
Internal Medicine71716%$235,1010.68%29,81642
Nurse Practitioner79018%$219,0110.63%27,79835
Physician Assistant54712%$164,3990.47%20,88738
Obstetrics & Gynecology952.1%$43,5810.13%5,54058
Emergency Medicine942.1%$20,1020.06%2,55927
Nephrology240.53%$6,5130.02%82634

Not listed: 19 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 87086 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