HCPCS 87086

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

Laboratory Work RVU per service none (2020 fee schedule; adds 0 work RVUs)

5,092
95th percentile among 6,116 codes billed · 2020
$34M
95th percentile among 6,116 codes billed · 2020
4.2M
98th percentile among 6,116 codes billed · 2020
31
62nd percentile among 6,116 codes billed · 2020
1,035
89th percentile among 6,116 codes billed · 2020

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
Florida369$4,116,253513,933571,894
California138$3,615,208451,70726412,162
Texas501$3,473,554433,60332507
New Jersey140$2,999,495374,036274,177
North Carolina206$2,966,901370,34446329
Ohio62$1,675,277209,073568,630
New York577$1,633,459203,75928528
Arizona137$1,272,454158,92564603
Illinois49$1,050,226131,2152688,637
Alabama63$1,045,797130,578521,186
Tennessee69$1,011,639126,366354,443
Massachusetts389$984,018122,76124122
Georgia101$879,001109,71639353
Pennsylvania22$836,890104,3991,12116,003
Kansas30$675,66984,272467,584

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

Not listed: 11 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ352$4,355,531543,11639
Tampa-St. Petersburg-Clearwater, FL20$2,188,037273,08355
Los Angeles-Long Beach-Anaheim, CA95$1,812,651226,199262
Dallas-Fort Worth-Arlington, TX163$1,564,647195,31246
Miami-Fort Lauderdale-West Palm Beach, FL33$1,379,727172,205344
Phoenix-Mesa-Chandler, AZ26$1,205,578150,570368
Chicago-Naperville-Elgin, IL-IN44$1,036,867129,568282
Birmingham, AL32$996,424124,38868
Boston-Cambridge-Newton, MA-NH383$947,206118,14924
Houston-Pasadena-The Woodlands, TX19$906,416113,10234
Atlanta-Sandy Springs-Roswell, GA35$834,629104,12425
Austin-Round Rock-San Marcos, TX131$761,66495,07920
Seattle-Tacoma-Bellevue, WA112$579,69972,46420
Nashville-Davidson--Murfreesboro--Franklin, TN34$519,20764,91453
Cincinnati, OH-KY-IN36$490,06061,18853

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 42 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing 87086 nationally

Clinical Laboratory accounts for 92% of payment for 87086 nationally in 2020, across 15 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory57511%$30,984,43192%3,867,6206,726
Urology67413%$932,9322.8%116,823173
Pathology360.71%$564,2561.7%70,6171,962
Family Practice1,30626%$428,2491.3%53,72741
Internal Medicine1,00520%$413,1811.2%51,80652
Nurse Practitioner70714%$213,6880.63%26,76738
Physician Assistant4388.6%$133,2530.39%16,68838
Obstetrics & Gynecology1442.8%$45,8880.14%5,75740
Hematology-Oncology190.37%$35,7490.11%4,461235
Emergency Medicine621.2%$15,9660.05%2,00032
Nephrology360.71%$12,5150.04%1,56744
Pediatric Medicine120.24%$8,3450.02%1,03786
Geriatric Medicine120.24%$4,1100.01%51243
Rheumatology120.24%$3,7110.01%46439
Endocrinology110.22%$2,599<0.01%32630

Not listed: 12 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 2020.

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