HCPCS 87086
Laboratory test (ClaimLight category; the code descriptor is not shown)
Laboratory Work RVU per service none (2022 fee schedule; adds 0 work RVUs)
Trend
Medicare payment on the code
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.
Billers
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 | |
|---|---|---|---|---|---|---|---|
| 2024 | 4,506 | $34,813,358 | -1% | 4,406,190 | 30 | 1,478 | 0.00 |
| 2023 | 5,074 | $35,223,975 | +2% | 4,458,847 | 32 | 1,125 | 0.00 |
| 2022 | 4,851 | $34,475,594 | -1% | 4,331,371 | 31 | 1,177 | 0.00 |
| 2021 | 4,801 | $34,974,603 | +3% | 4,338,655 | 32 | 1,295 | 0.00 |
| 2020 | 5,092 | $33,809,775 | first year in data | 4,221,535 | 31 | 1,035 | 0.00 |
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 Jersey | 348 | $3,914,014 | 491,565 | 34 | 412 | |
| Florida | 403 | $3,836,279 | 481,300 | 48 | 1,362 | |
| California | 124 | $3,731,860 | 469,285 | 196 | 12,734 | |
| Texas | 425 | $3,333,168 | 418,594 | 30 | 591 | |
| North Carolina | 191 | $2,978,494 | 374,050 | 43 | 277 | |
| New York | 574 | $1,743,652 | 218,966 | 28 | 592 | |
| Ohio | 55 | $1,481,944 | 186,084 | 67 | 11,399 | |
| Arizona | 156 | $1,362,665 | 171,131 | 40 | 511 | |
| Tennessee | 69 | $1,114,309 | 140,064 | 43 | 4,390 | |
| Illinois | 52 | $1,069,714 | 134,515 | 253 | 8,715 | |
| Alabama | 55 | $994,608 | 125,064 | 86 | 2,445 | |
| Massachusetts | 365 | $936,628 | 117,588 | 25 | 123 | |
| Georgia | 83 | $904,071 | 113,580 | 38 | 508 | |
| Kansas | 19 | $829,015 | 104,064 | 66 | 13,425 | |
| Pennsylvania | 28 | $619,173 | 77,792 | 240 | 13,644 |
Not listed: 1 billers with an armed-forces or unknown state code (AA); they are in the national totals.
Not listed: 13 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-NJ | 541 | $5,345,774 | 671,224 | 35 | |
| Tampa-St. Petersburg-Clearwater, FL | 18 | $2,066,530 | 259,263 | 48 | |
| Los Angeles-Long Beach-Anaheim, CA | 83 | $1,828,252 | 229,640 | 202 | |
| Dallas-Fort Worth-Arlington, TX | 185 | $1,582,417 | 198,780 | 38 | |
| Phoenix-Mesa-Chandler, AZ | 26 | $1,305,106 | 163,882 | 337 | |
| Miami-Fort Lauderdale-West Palm Beach, FL | 31 | $1,241,377 | 155,701 | 417 | |
| Chicago-Naperville-Elgin, IL-IN | 46 | $1,104,853 | 138,918 | 227 | |
| Birmingham, AL | 38 | $916,452 | 115,210 | 82 | |
| Boston-Cambridge-Newton, MA-NH | 359 | $903,347 | 113,407 | 25 | |
| Atlanta-Sandy Springs-Roswell, GA | 27 | $861,482 | 108,140 | 38 | |
| Austin-Round Rock-San Marcos, TX | 115 | $762,249 | 95,641 | 21 | |
| Nashville-Davidson--Murfreesboro--Franklin, TN | 30 | $611,259 | 76,875 | 59 | |
| Seattle-Tacoma-Bellevue, WA | 125 | $544,961 | 68,657 | 21 | |
| Baltimore-Columbia-Towson, MD | 18 | $386,375 | 48,529 | 52 | |
| Milwaukee-Waukesha, WI | 18 | $308,250 | 38,998 | 35 |
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 40 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 87086 nationally
Clinical Laboratory accounts for 91% of payment for 87086 nationally in 2022, across 13 specialties on claims.
| observed | calculated | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|---|
| Clinical Laboratory | 546 | 11% | $31,539,801 | 91% | 3,961,258 | 7,255 |
| Urology | 631 | 13% | $885,714 | 2.6% | 111,589 | 177 |
| Pathology | 36 | 0.74% | $767,937 | 2.2% | 96,548 | 2,682 |
| Family Practice | 1,138 | 23% | $377,198 | 1.1% | 47,605 | 42 |
| Internal Medicine | 879 | 18% | $343,847 | 1.00% | 43,498 | 49 |
| Nurse Practitioner | 760 | 16% | $226,288 | 0.66% | 28,531 | 38 |
| Physician Assistant | 511 | 11% | $168,175 | 0.49% | 21,224 | 42 |
| Obstetrics & Gynecology | 128 | 2.6% | $50,976 | 0.15% | 6,445 | 50 |
| Hematology-Oncology | 11 | 0.23% | $42,257 | 0.12% | 5,309 | 483 |
| Emergency Medicine | 110 | 2.3% | $29,581 | 0.09% | 3,743 | 34 |
| Pediatric Medicine | 11 | 0.23% | $14,088 | 0.04% | 1,773 | 161 |
| Nephrology | 26 | 0.54% | $8,656 | 0.03% | 1,097 | 42 |
| Rheumatology | 11 | 0.23% | $3,113 | <0.01% | 391 | 36 |
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 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