HCPCS 87428

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

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

4,293
94th percentile among 6,253 codes billed · 2021
$11M
89th percentile among 6,253 codes billed · 2021
163K
88th percentile among 6,253 codes billed · 2021
23
48th percentile among 6,253 codes billed · 2021
117
59th percentile among 6,253 codes billed · 2021
+1266.5%
Medicare payment on the code vs 2020; billers +770.8% · 2021

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
Texas586$1,420,97619,4592096
Tennessee340$1,335,90921,03451146
Mississippi308$1,196,11616,42236154
Florida254$784,33810,72426120
Louisiana177$681,9869,33632170
Kentucky213$554,5458,72826120
Georgia270$533,4798,5172286
Alabama181$466,5567,37027106
North Carolina209$442,3646,9832393
Virginia268$437,7286,7602050
Maryland157$353,2094,8402259
Indiana133$273,6734,38218103
Pennsylvania115$273,3753,7442579
Oklahoma81$237,4463,24625113
Arkansas91$205,7962,8052366

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

Not listed: 15 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
Dallas-Fort Worth-Arlington, TX140$328,0554,49819
Mississippi outside metro areas63$294,2954,04050
Lake Charles, LA35$249,8693,41089
Tupelo, MS59$246,0283,37139
Nashville-Davidson--Murfreesboro--Franklin, TN70$234,8703,68537
Jackson, MS76$228,5583,14129
Cape Coral-Fort Myers, FL75$226,6293,09325
Baltimore-Columbia-Towson, MD96$211,9882,89720
Tennessee outside metro areas51$211,6093,32650
Kentucky outside metro areas70$207,5753,26137
Washington-Arlington-Alexandria, DC-VA-MD-WV111$194,3712,80519
Orlando-Kissimmee-Sanford, FL39$173,9942,37733
Atlanta-Sandy Springs-Roswell, GA96$171,8652,70120
New York-Newark-Jersey City, NY-NJ44$163,5492,37119
Chicago-Naperville-Elgin, IL-IN56$145,0382,29422

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 82 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 87428 nationally

Nurse Practitioner accounts for 43% of payment for 87428 nationally in 2021, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner1,71540%$4,742,57643%70,30441
Family Practice1,17427%$2,794,58025%41,17035
Physician Assistant71217%$1,601,76815%23,80833
Internal Medicine43310%$979,0478.9%14,33333
Emergency Medicine1483.4%$514,9004.7%7,42950
Clinical Laboratory200.47%$137,3321.2%2,090105
Pediatric Medicine190.44%$56,8820.52%79342
General Practice220.51%$53,9020.49%80236

Not listed: 24 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 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