HCPCS 87086

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

Laboratory Work RVU per service none (2021 fee schedule; adds 0 work RVUs)

4,801
94th percentile among 6,253 codes billed · 2021
$35M
94th percentile among 6,253 codes billed · 2021
4.3M
98th percentile among 6,253 codes billed · 2021
32
62nd percentile among 6,253 codes billed · 2021
1,295
90th percentile among 6,253 codes billed · 2021
+3.4%
Medicare payment on the code vs 2020; billers -5.7% · 2021

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
Florida372$3,995,777495,368581,822
California117$3,750,992465,59430012,344
New Jersey116$3,685,926456,8812911,895
Texas416$3,413,122423,28234618
North Carolina211$3,113,457386,10345234
New York594$1,790,529222,01130596
Ohio61$1,715,260212,6646310,543
Arizona151$1,350,908167,54443704
Tennessee70$1,081,751134,286414,527
Illinois44$1,046,334129,8292829,581
Alabama52$1,022,075126,799691,936
Massachusetts383$995,503123,4052590
Georgia94$911,990113,10038518
Kansas24$803,95099,649286,897
Pennsylvania22$762,72794,5781,41117,171

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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ334$5,228,057648,01239
Tampa-St. Petersburg-Clearwater, FL24$2,134,800264,60737
Los Angeles-Long Beach-Anaheim, CA75$1,849,574229,328300
Dallas-Fort Worth-Arlington, TX156$1,648,298204,46253
Miami-Fort Lauderdale-West Palm Beach, FL29$1,316,126163,112756
Phoenix-Mesa-Chandler, AZ25$1,290,352160,031518
Chicago-Naperville-Elgin, IL-IN40$1,043,958129,549282
Boston-Cambridge-Newton, MA-NH386$970,069120,23425
Birmingham, AL33$964,361119,60569
Houston-Pasadena-The Woodlands, TX18$890,152110,38847
Atlanta-Sandy Springs-Roswell, GA30$856,515106,15136
Austin-Round Rock-San Marcos, TX128$767,84795,16723
Nashville-Davidson--Murfreesboro--Franklin, TN31$590,20373,31056
Seattle-Tacoma-Bellevue, WA106$583,31672,55319
Cincinnati, OH-KY-IN38$421,04652,19160

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 44 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.

Specialties billing 87086 nationally

Clinical Laboratory accounts for 92% of payment for 87086 nationally in 2021, across 13 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory54011%$32,007,79692%3,969,4727,351
Urology55211%$927,4092.7%115,299209
Pathology370.77%$687,0412.0%85,4002,308
Family Practice1,23826%$431,0191.2%53,62143
Internal Medicine91019%$383,3091.1%47,86953
Nurse Practitioner74015%$232,9310.67%28,95639
Physician Assistant4689.7%$154,4300.44%19,22941
Obstetrics & Gynecology1162.4%$45,2330.13%5,64449
Hematology-Oncology160.33%$41,3210.12%5,124320
Emergency Medicine701.5%$18,6830.05%2,32733
Nephrology280.58%$8,7880.03%1,09739
Rheumatology180.37%$4,2570.01%52929
Endocrinology120.25%$2,453<0.01%30425

Not listed: 18 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 2021.

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