HCPCS 87481

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

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

1,336
88th percentile among 6,326 codes billed · 2022
$49M
96th percentile among 6,326 codes billed · 2022
1.4M
96th percentile among 6,326 codes billed · 2022
148
90th percentile among 6,326 codes billed · 2022
4,073
96th percentile among 6,326 codes billed · 2022
+32.1%
Medicare payment on the code vs 2021; billers +12.4% · 2022

Trend

Medicare payment on the code

$0$50M$100M2020: $22M paid20202021: $37M paid20212022: $49M paid20222023: $67M paid20232024: $100M paid2024$100M$0$50M$100M2020: $22M paid20202021: $37M paid20212022: $49M paid20222023: $67M paid20232024: $100M paid2024$100M$0$50M$100M2020: $22M paid20202021: $37M paid20212022: $49M paid20222023: $67M paid20232024: $100M paid2024$100M$0$50M$100M2020: $22M paid20202021: $37M paid20212022: $49M paid20222023: $67M paid20232024: $100M paid2024$100M

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

Billers

05001,0002020: 777 providers20202021: 1,189 providers20212022: 1,336 providers20222023: 1,117 providers20232024: 1,217 providers20241,21705001,0002020: 777 providers20202021: 1,189 providers20212022: 1,336 providers20222023: 1,117 providers20232024: 1,217 providers20241,21705001,0002020: 777 providers20202021: 1,189 providers20212022: 1,336 providers20222023: 1,117 providers20232024: 1,217 providers20241,21705001,0002020: 777 providers20202021: 1,189 providers20212022: 1,336 providers20222023: 1,117 providers20232024: 1,217 providers20241,217

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
20241,217$99,973,379+48%2,935,87421910,6960.00
20231,117$67,486,686+38% (2023 changed hospital and observation visit codes)1,975,3471587,7070.00
20221,336$48,951,095+32%1,416,0521484,0730.00
20211,189$37,043,571– (Not compared: 2021 changed office visit values)1,057,4191252,8160.00
2020777$22,483,522first year in data646,305993,3950.00

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
Pennsylvania18$8,552,810247,58536079,613
California134$8,443,195243,4812628,742
Texas212$6,799,617196,8931733,873
South Carolina16$2,469,12570,60222718,514
Oklahoma37$2,367,33068,6064273,443
Florida67$2,228,92764,3862503,486
New Jersey33$2,216,57665,3082505,506
Maryland44$2,018,02158,3741557,687
Alabama37$1,759,00151,1872855,136
New York83$1,470,54842,635462,777
Georgia55$1,045,84730,0221612,374
Mississippi24$803,00523,2995152,735
Arizona64$798,62623,035187620
Virginia31$775,48222,3762523,108
Louisiana16$690,96720,0213364,642

Not listed: 13 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
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD18$8,195,707237,25173
Los Angeles-Long Beach-Anaheim, CA75$7,118,210205,403333
Dallas-Fort Worth-Arlington, TX84$3,689,197106,821250
New York-Newark-Jersey City, NY-NJ92$2,281,04367,29974
Oklahoma City, OK23$2,033,90458,976509
Houston-Pasadena-The Woodlands, TX51$1,981,34857,334390
Baltimore-Columbia-Towson, MD31$1,330,49738,480151
Washington-Arlington-Alexandria, DC-VA-MD-WV17$864,40724,999250
Phoenix-Mesa-Chandler, AZ59$752,69821,708184
San Antonio-New Braunfels, TX47$700,71220,315129
Atlanta-Sandy Springs-Roswell, GA28$638,20418,326133
Chicago-Naperville-Elgin, IL-IN36$514,25814,929110
Little Rock-North Little Rock-Conway, AR17$485,56114,046144
Raleigh-Cary, NC13$482,62613,909130
Richmond, VA13$469,62213,547764

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 25 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 87481 nationally

Clinical Laboratory accounts for 74% of payment for 87481 nationally in 2022, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory35426%$36,464,42474%1,055,4282,981
Urology57143%$6,813,10814%196,644344
Pathology785.8%$2,868,3095.9%82,8881,063
Podiatry1047.8%$1,645,8033.4%47,511457
Nurse Practitioner624.6%$347,9810.71%10,069162
Physician Assistant392.9%$266,0040.54%7,705198
Obstetrics & Gynecology695.2%$231,0180.47%6,65796
Family Practice181.3%$130,2640.27%3,773210
Internal Medicine151.1%$92,7970.19%2,696180

Not listed: 12 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 87481 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