HCPCS 87428

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

Laboratory Work RVU per service none (2023 fee schedule; adds 0 work RVUs)

10,591
97th percentile among 6,405 codes billed · 2023
$17M
91st percentile among 6,405 codes billed · 2023
362K
92nd percentile among 6,405 codes billed · 2023
22
46th percentile among 6,405 codes billed · 2023
96
54th percentile among 6,405 codes billed · 2023
+60.0%
Medicare payment on the code vs 2022; billers +13.7% · 2023

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
Texas1,352$2,247,63042,2012188
Virginia734$1,449,82730,80128112
Florida694$1,385,73025,11521111
Maryland342$1,070,14919,57639154
Georgia493$897,92219,57825110
North Carolina463$754,65017,0592182
New Jersey405$748,05815,29225104
Mississippi248$685,78312,71537151
Indiana469$647,18713,6752074
Pennsylvania275$643,99611,64625131
New York465$536,16617,3132892
Kentucky574$514,43116,1822165
South Carolina306$468,96610,6062495
California255$422,1028,7731989
Tennessee291$412,0788,9852275

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

Not listed: 7 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ683$952,99825,72727
Baltimore-Columbia-Towson, MD188$712,77812,94658
Washington-Arlington-Alexandria, DC-VA-MD-WV291$637,02912,08228
Dallas-Fort Worth-Arlington, TX385$580,43411,22021
Atlanta-Sandy Springs-Roswell, GA233$434,2639,46825
Virginia Beach-Chesapeake-Norfolk, VA-NC168$399,6258,58137
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD146$390,3177,15334
Richmond, VA150$315,7766,66931
Houston-Pasadena-The Woodlands, TX244$311,4305,30918
Cape Coral-Fort Myers, FL140$300,7775,66625
Miami-Fort Lauderdale-West Palm Beach, FL109$275,3424,94136
Chicago-Naperville-Elgin, IL-IN146$254,4716,04825
Mississippi outside metro areas70$214,4294,02647
Louisville/Jefferson County, KY-IN247$213,5696,42920
Indianapolis-Carmel-Greenwood, IN172$188,1373,74817

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 2023.

Specialties billing 87428 nationally

Nurse Practitioner accounts for 32% of payment for 87428 nationally in 2023, across 10 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner3,85936%$5,438,54632%116,31130
Family Practice2,86627%$5,082,55130%106,41537
Physician Assistant2,09520%$3,214,56919%69,38333
Internal Medicine1,14411%$1,848,11311%39,72935
Emergency Medicine4414.2%$914,0285.4%20,63047
Clinical Laboratory130.12%$135,7300.80%3,630279
General Practice560.53%$105,2960.62%2,17139
Pediatric Medicine210.20%$48,7740.29%93444
Allergy/ Immunology130.12%$14,9800.09%26320
Hospitalist170.16%$13,6140.08%31919

Not listed: 25 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 2023.

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