HCPCS 87428

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

Laboratory

493
80th percentile among 6,116 codes billed · 2020
$805K
68th percentile among 6,116 codes billed · 2020
12K
69th percentile among 6,116 codes billed · 2020
17
31st percentile among 6,116 codes billed · 2020
55
42nd percentile among 6,116 codes billed · 2020

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
Texas84$172,9422,3722265
Florida48$123,1871,6793285
Tennessee73$83,9601,3181630
Louisiana48$80,6191,1021945
Alabama24$46,2227391952
Mississippi34$45,5826231735
North Carolina26$37,8735951754
Kentucky33$29,3154611319
Massachusetts17$23,0203622135
Virginia18$22,9463541635
Georgia16$14,9442351324

Not listed: 22 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
Orlando-Kissimmee-Sanford, FL13$52,71071962
Tampa-St. Petersburg-Clearwater, FL12$26,60336237
Dallas-Fort Worth-Arlington, TX14$25,64834920
Tennessee outside metro areas15$17,99628316
Jackson, MS12$13,52218413
Virginia Beach-Chesapeake-Norfolk, VA-NC11$12,96319715

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 6 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 87428 nationally

Nurse Practitioner accounts for 40% of payment for 87428 nationally in 2020, across 5 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner24149%$324,30640%4,73320
Family Practice10120%$180,80122%2,64526
Physician Assistant6814%$147,40818%2,10531
Emergency Medicine377.5%$62,7867.8%88824
Internal Medicine316.3%$55,9326.9%80226

Not listed: 8 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 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