HCPCS 87635

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

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

9,976
97th percentile among 6,405 codes billed · 2023
$47M
96th percentile among 6,405 codes billed · 2023
932K
95th percentile among 6,405 codes billed · 2023
25
52nd percentile among 6,405 codes billed · 2023
150
63rd percentile among 6,405 codes billed · 2023
+5.2%
Medicare payment on the code vs 2022; billers -30.1%. 2023 changed hospital and observation visit codes · 2023

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
California938$12,146,445241,70232758
New York724$5,653,111112,60832176
Illinois468$3,769,17375,04832178
New Jersey259$3,764,66874,98226456
Texas415$2,226,35144,39726225
North Carolina587$1,893,77137,8792284
Florida192$1,559,95131,10527686
Tennessee600$1,387,36427,84725127
Pennsylvania331$1,129,61722,52022102
South Carolina394$1,019,37220,52433123
Georgia483$891,39117,9362493
Alabama311$809,32816,23631129
Massachusetts268$711,18514,16923141
Missouri232$670,46313,40233123
Arizona53$646,76712,878222,012

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

Not listed: 5 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-NJ700$8,906,285177,33935
Los Angeles-Long Beach-Anaheim, CA311$7,132,244141,90344
Chicago-Naperville-Elgin, IL-IN346$3,451,71568,70633
San Francisco-Oakland-Fremont, CA153$1,432,50128,49633
Riverside-San Bernardino-Ontario, CA38$1,184,56523,56428
Dallas-Fort Worth-Arlington, TX87$1,054,54121,02228
Oxnard-Thousand Oaks-Ventura, CA25$939,78518,69227
Miami-Fort Lauderdale-West Palm Beach, FL55$856,64617,06327
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD117$674,61313,43126
Phoenix-Mesa-Chandler, AZ28$614,77612,23824
Atlanta-Sandy Springs-Roswell, GA289$541,75710,80423
Charlotte-Concord-Gastonia, NC-SC339$537,32110,80122
St. Louis, MO-IL128$516,58410,32160
Boston-Cambridge-Newton, MA-NH183$500,8189,97922
Houston-Pasadena-The Woodlands, TX73$444,5428,85630

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 89 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 87635 nationally

Clinical Laboratory accounts for 61% of payment for 87635 nationally in 2023, across 14 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory5755.8%$28,549,97361%568,219988
Nurse Practitioner3,10831%$5,407,54112%108,40235
Family Practice2,29823%$4,412,7149.4%88,48639
Physician Assistant2,15422%$3,853,1808.3%77,03236
Internal Medicine1,00910%$2,150,1194.6%43,10943
Emergency Medicine4444.5%$996,7492.1%19,90245
Pathology320.32%$380,5060.81%7,592237
Pulmonary Disease640.64%$151,2000.32%3,02847
General Practice640.64%$130,0780.28%2,60441
Gastroenterology460.46%$104,5750.22%2,10046
Geriatric Medicine220.22%$59,0790.13%1,17553
Cardiology220.22%$49,3640.11%98545
Urology130.13%$16,4420.04%33326
Hospitalist110.11%$16,3410.03%32730

Not listed: 36 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 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