HCPCS 87428

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

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

12,291
98th percentile among 6,471 codes billed · 2024
$30M
94th percentile among 6,471 codes billed · 2024
444K
93rd percentile among 6,471 codes billed · 2024
23
47th percentile among 6,471 codes billed · 2024
103
55th percentile among 6,471 codes billed · 2024
+75.6%
Medicare payment on the code vs 2023; billers +16.1% · 2024

Trend

Medicare payment on the code

$0$20M2020: $805K paid20202021: $11M paid20212022: $11M paid20222023: $17M paid20232024: $30M paid2024$30M$0$20M2020: $805K paid20202021: $11M paid20212022: $11M paid20222023: $17M paid20232024: $30M paid2024$30M$0$20M2020: $805K paid20202021: $11M paid20212022: $11M paid20222023: $17M paid20232024: $30M paid2024$30M$0$20M2020: $805K paid20202021: $11M paid20212022: $11M paid20222023: $17M paid20232024: $30M paid2024$30M

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

Billers

05,00010K2020: 493 providers20202021: 4,293 providers20212022: 9,316 providers20222023: 11K providers20232024: 12K providers202412K05,00010K2020: 493 providers20202021: 4,293 providers20212022: 9,316 providers20222023: 11K providers20232024: 12K providers202412K05,00010K2020: 493 providers20202021: 4,293 providers20212022: 9,316 providers20222023: 11K providers20232024: 12K providers202412K05,00010K2020: 493 providers20202021: 4,293 providers20212022: 9,316 providers20222023: 11K providers20232024: 12K providers202412K

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
202412,291$29,768,410+76%443,757231030.00
202310,591$16,953,980+60%362,48622960.00
20229,316$10,597,928-4%349,215231120.00
20214,293$11,004,304+1266%162,547231170.00
2020493$805,308first year in data11,6691755

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 York771$3,646,81553,62544200
Texas1,484$3,227,27148,0302286
Florida808$2,032,01530,22524110
Virginia741$1,838,56427,15925101
New Jersey496$1,750,85925,94736143
Georgia545$1,392,00220,58424104
North Carolina508$1,380,42720,2732177
Kentucky710$1,277,00619,7792066
South Carolina457$1,057,18115,7612293
Indiana512$1,037,38115,4372084
Maryland376$1,022,60315,46931104
California410$937,62114,0392087
Tennessee314$702,64110,3532278
Mississippi217$701,59410,61336132
Arkansas292$666,8429,9452395

Not listed: 2 billers with an armed-forces or unknown state code (AP, ZZ); they are in the national totals.

Not listed: 6 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-NJ984$4,757,26870,12850
Dallas-Fort Worth-Arlington, TX490$1,024,00815,26122
Washington-Arlington-Alexandria, DC-VA-MD-WV307$666,21710,01723
Atlanta-Sandy Springs-Roswell, GA250$647,7399,48923
Baltimore-Columbia-Towson, MD195$621,3039,41043
Virginia Beach-Chesapeake-Norfolk, VA-NC167$548,3728,06834
Chicago-Naperville-Elgin, IL-IN183$486,5897,25224
Louisville/Jefferson County, KY-IN265$468,3547,27122
Miami-Fort Lauderdale-West Palm Beach, FL151$447,4316,61730
Cape Coral-Fort Myers, FL123$446,4626,65830
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD189$425,9516,33823
Richmond, VA156$367,6145,38926
Asheville, NC19$330,0084,80226
Indianapolis-Carmel-Greenwood, IN189$298,3134,39718
Cincinnati, OH-KY-IN200$277,6384,09516

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 98 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 87428 nationally

Nurse Practitioner accounts for 31% of payment for 87428 nationally in 2024, across 10 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner4,49837%$9,275,22131%138,27531
Family Practice3,32327%$8,141,54527%121,86737
Physician Assistant2,39619%$5,947,11120%88,40637
Internal Medicine1,35811%$2,925,5589.8%43,92332
Emergency Medicine5164.2%$2,510,0278.4%36,93372
Clinical Laboratory130.11%$472,2331.6%6,946534
General Practice590.48%$151,2510.51%2,26638
Hospitalist240.20%$52,1390.18%76932
Pediatric Medicine220.18%$46,1560.16%69532
Allergy/ Immunology110.09%$17,9270.06%27525

Not listed: 20 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 87428 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