HCPCS 87631

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

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

583
81st percentile among 6,326 codes billed · 2022
$18M
92nd percentile among 6,326 codes billed · 2022
129K
87th percentile among 6,326 codes billed · 2022
36
66th percentile among 6,326 codes billed · 2022
957
87th percentile among 6,326 codes billed · 2022
-33.0%
Medicare payment on the code vs 2021; billers +11.7% · 2022

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
California47$6,388,81045,2173025,104
Texas61$3,374,27024,530691,004
New York79$1,057,8727,51226457
Pennsylvania38$1,009,4987,18927732
New Jersey37$877,6556,29541924
Alabama24$755,8235,587107684
Florida37$747,2935,32955430
Louisiana14$447,4893,17642962
Illinois49$290,2112,0713077
Colorado11$187,8661,34132529
North Carolina13$107,65176424224
Georgia11$106,90776047181
Michigan13$96,67968734129
Arkansas11$86,93262120206
Tennessee11$78,98869122239

Not listed: 29 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
Los Angeles-Long Beach-Anaheim, CA34$5,608,62139,686421
Dallas-Fort Worth-Arlington, TX19$2,282,26616,672133
New York-Newark-Jersey City, NY-NJ101$1,821,73512,99828
Houston-Pasadena-The Woodlands, TX15$697,1904,93481
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD12$695,6934,95633
Chicago-Naperville-Elgin, IL-IN49$290,2112,07130
Miami-Fort Lauderdale-West Palm Beach, FL12$215,9381,53481
Detroit-Warren-Dearborn, MI11$83,22459134

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 8 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 87631 nationally

Clinical Laboratory accounts for 86% of payment for 87631 nationally in 2022, across 6 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory24041%$15,608,08586%111,126463
Internal Medicine9416%$843,1414.7%6,36168
Family Practice10117%$741,0984.1%5,39253
Emergency Medicine345.8%$196,7661.1%1,40741
Nurse Practitioner417.0%$132,5690.73%97024
Physician Assistant396.7%$117,3930.65%83821

Not listed: 16 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 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