HCPCS 87428

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

Laboratory Work RVU per service none (2022 fee schedule; adds 0 work RVUs)

9,316
97th percentile among 6,326 codes billed · 2022
$11M
89th percentile among 6,326 codes billed · 2022
349K
92nd percentile among 6,326 codes billed · 2022
23
48th percentile among 6,326 codes billed · 2022
112
58th percentile among 6,326 codes billed · 2022
-3.7%
Medicare payment on the code vs 2021; billers +117.0% · 2022

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
Texas1,083$1,073,16335,2922288
Virginia697$952,05431,43929142
Maryland327$745,06524,60651227
Georgia585$726,80624,03827118
Florida450$533,28917,52222137
Kentucky563$502,52416,5542172
Pennsylvania302$485,48815,93927191
Indiana506$471,89915,5432091
Mississippi290$445,67814,71930141
New Jersey256$377,86612,41827124
Arkansas291$349,47511,46125104
North Carolina367$341,70311,2462276
Tennessee308$310,56210,2422295
Illinois272$255,5688,4182164
Alabama236$254,8898,4682683

Not listed: 3 billers with an armed-forces or unknown state code (ZZ); they are in the national totals.

Not listed: 4 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
Baltimore-Columbia-Towson, MD181$510,98616,81670
Washington-Arlington-Alexandria, DC-VA-MD-WV281$447,74714,78036
New York-Newark-Jersey City, NY-NJ301$415,34113,64727
Atlanta-Sandy Springs-Roswell, GA281$355,33311,71027
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD139$296,1779,72042
Dallas-Fort Worth-Arlington, TX295$250,3028,21120
Virginia Beach-Chesapeake-Norfolk, VA-NC168$246,1348,14632
Richmond, VA139$221,1467,29935
Chicago-Naperville-Elgin, IL-IN118$181,2565,98332
Louisville/Jefferson County, KY-IN219$165,1655,43620
Cape Coral-Fort Myers, FL110$150,9514,94731
Tupelo, MS62$149,5064,94958
Boston-Cambridge-Newton, MA-NH137$147,7634,84528
Indianapolis-Carmel-Greenwood, IN198$127,1274,17417
Houston-Pasadena-The Woodlands, TX178$125,8654,13719

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 94 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 87428 nationally

Nurse Practitioner accounts for 32% of payment for 87428 nationally in 2022, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner3,58238%$3,386,35132%111,50831
Family Practice2,56528%$3,300,15031%108,91042
Physician Assistant1,72419%$1,810,40017%59,62835
Internal Medicine95810%$1,250,66112%41,20243
Emergency Medicine2973.2%$533,6545.0%17,53759
Clinical Laboratory200.21%$79,3640.75%2,622131
General Practice440.47%$64,6030.61%2,12948
Pediatric Medicine240.26%$47,0660.44%1,55065
Allergy/ Immunology170.18%$16,8910.16%55833

Not listed: 26 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 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