HCPCS 87631

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

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

522
80th percentile among 6,253 codes billed · 2021
$27M
93rd percentile among 6,253 codes billed · 2021
189K
89th percentile among 6,253 codes billed · 2021
32
62nd percentile among 6,253 codes billed · 2021
1,222
90th percentile among 6,253 codes billed · 2021
+1.5%
Medicare payment on the code vs 2020; billers +47.9% · 2021

Trend

Medicare payment on the code

$0$20M2020: $27M paid20202021: $27M paid20212022: $18M paid20222023: $21M paid20232024: $35M paid2024$35M$0$20M2020: $27M paid20202021: $27M paid20212022: $18M paid20222023: $21M paid20232024: $35M paid2024$35M$0$20M2020: $27M paid20202021: $27M paid20212022: $18M paid20222023: $21M paid20232024: $35M paid2024$35M$0$20M2020: $27M paid20202021: $27M paid20212022: $18M paid20222023: $21M paid20232024: $35M paid2024$35M

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

Billers

05002020: 353 providers20202021: 522 providers20212022: 583 providers20222023: 636 providers20232024: 778 providers202477805002020: 353 providers20202021: 522 providers20212022: 583 providers20222023: 636 providers20232024: 778 providers202477805002020: 353 providers20202021: 522 providers20212022: 583 providers20222023: 636 providers20232024: 778 providers202477805002020: 353 providers20202021: 522 providers20212022: 583 providers20222023: 636 providers20232024: 778 providers2024778

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
2024778$35,027,874+70%251,176321,3010.00
2023636$20,552,882+14%147,604321,0120.00
2022583$18,045,728-33%129,039369570.00
2021522$26,915,103+1%189,407321,2220.00
2020353$26,525,031first year in data186,822342,0930.00

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
California51$11,635,10581,5804544,836
Texas45$4,618,25732,561562,336
New York60$1,771,43512,42422501
Georgia12$1,483,99310,405244,583
Pennsylvania27$887,7296,22430875
Alabama28$553,0244,01350423
Louisiana16$550,7423,87132938
Florida31$525,5493,69263421
New Jersey33$254,3431,79734144
Arkansas27$212,9221,50023164
North Carolina23$166,5591,16832133
Missouri11$150,9031,05817457
Tennessee17$131,81098832145
Colorado11$117,32982942259
Illinois24$104,3527352185

Not listed: 25 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
Los Angeles-Long Beach-Anaheim, CA40$11,208,57278,589700
New York-Newark-Jersey City, NY-NJ81$1,878,44113,18826
Houston-Pasadena-The Woodlands, TX14$1,414,7289,920169
Arkansas outside metro areas17$123,55687221
Charlotte-Concord-Gastonia, NC-SC14$107,79575636
Chicago-Naperville-Elgin, IL-IN24$104,35273521
Detroit-Warren-Dearborn, MI13$53,84437817

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 7 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 87631 nationally

Clinical Laboratory accounts for 92% of payment for 87631 nationally in 2021, across 6 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory19137%$24,633,65292%173,076906
Internal Medicine8717%$860,0963.2%6,22071
Family Practice9719%$742,2522.8%5,30155
Nurse Practitioner6011%$223,0650.83%1,58426
Physician Assistant244.6%$87,1600.32%62926
Emergency Medicine203.8%$58,3810.22%41121

Not listed: 22 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 87631 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