HCPCS 87635

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

Laboratory

5,821
95th percentile among 6,116 codes billed · 2020
$21M
93rd percentile among 6,116 codes billed · 2020
417K
93rd percentile among 6,116 codes billed · 2020
28
58th percentile among 6,116 codes billed · 2020
198
69th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$20M$40M2020: $21M paid20202021: $41M paid20212022: $44M paid20222023: $47M paid20232024: $40M paid2024$40M$0$20M$40M2020: $21M paid20202021: $41M paid20212022: $44M paid20222023: $47M paid20232024: $40M paid2024$40M$0$20M$40M2020: $21M paid20202021: $41M paid20212022: $44M paid20222023: $47M paid20232024: $40M paid2024$40M$0$20M$40M2020: $21M paid20202021: $41M paid20212022: $44M paid20222023: $47M paid20232024: $40M paid2024$40M

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

Billers

010K2020: 5,821 providers20202021: 13K providers20212022: 14K providers20222023: 9,976 providers20232024: 8,131 providers20248,131010K2020: 5,821 providers20202021: 13K providers20212022: 14K providers20222023: 9,976 providers20232024: 8,131 providers20248,131010K2020: 5,821 providers20202021: 13K providers20212022: 14K providers20222023: 9,976 providers20232024: 8,131 providers20248,131010K2020: 5,821 providers20202021: 13K providers20212022: 14K providers20222023: 9,976 providers20232024: 8,131 providers20248,131

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
20248,131$40,035,029-14%798,991231380.00
20239,976$46,700,410+5% (2023 changed hospital and observation visit codes)931,742251500.00
202214,278$44,401,744+8%879,838301750.00
202113,151$41,215,387– (Not compared: 2021 changed office visit values)806,032301830.00
20205,821$21,084,711first year in data416,73728198

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
California420$3,063,86662,16431324
New York642$1,960,25138,46133180
Texas460$1,455,57328,54824204
New Jersey232$1,379,22727,18838448
Florida234$1,283,63225,20940287
Louisiana337$925,64118,12338155
Alabama264$895,99217,60049148
Tennessee249$735,37014,39724158
South Carolina253$633,65612,41132110
Maryland116$531,60810,47949219
North Carolina230$486,2319,52823102
Georgia134$465,3769,19230186
Oklahoma108$454,9528,93745231
Massachusetts97$451,9208,86641257
Illinois74$430,9228,61828555

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

Not listed: 9 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ729$2,848,65756,03736
Los Angeles-Long Beach-Anaheim, CA171$2,121,84743,67731
Washington-Arlington-Alexandria, DC-VA-MD-WV100$537,38510,52549
Miami-Fort Lauderdale-West Palm Beach, FL47$448,0038,78547
Boston-Cambridge-Newton, MA-NH76$383,3967,52850
Houston-Pasadena-The Woodlands, TX74$353,6596,92820
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD71$337,8476,63522
Atlanta-Sandy Springs-Roswell, GA57$293,2785,77628
Dallas-Fort Worth-Arlington, TX62$292,7235,78339
Chicago-Naperville-Elgin, IL-IN55$288,9405,85925
Detroit-Warren-Dearborn, MI57$255,4675,02132
Birmingham, AL87$250,1404,90846
Memphis, TN-MS-AR85$235,3434,63726
Baltimore-Columbia-Towson, MD60$224,9914,45248
Nashville-Davidson--Murfreesboro--Franklin, TN52$210,3164,10329

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 81 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing 87635 nationally

Clinical Laboratory accounts for 33% of payment for 87635 nationally in 2020, across 21 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory3626.2%$6,916,80633%138,147382
Nurse Practitioner1,67829%$4,165,99420%81,61749
Family Practice1,23721%$3,011,45914%59,45148
Physician Assistant1,08819%$2,644,63313%51,65147
Internal Medicine64511%$1,459,4686.9%28,94545
Emergency Medicine2834.9%$907,4734.3%17,86363
Pathology250.43%$343,2741.6%6,930277
Gastroenterology951.6%$254,9461.2%4,98352
General Practice651.1%$204,6270.97%4,01062
Pediatric Medicine200.34%$149,9050.71%2,925146
Hematology-Oncology290.50%$102,7630.49%2,01870
Infectious Disease250.43%$87,7440.42%1,72069
Geriatric Medicine150.26%$79,6780.38%1,653110
Ophthalmology190.33%$55,3040.26%1,07957
General Surgery230.40%$51,3530.24%1,00444

Not listed: 35 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 2020.

Top billers of 87635 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