HCPCS 87640

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

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

1,174
86th percentile among 6,253 codes billed · 2021
$18M
91st percentile among 6,253 codes billed · 2021
509K
93rd percentile among 6,253 codes billed · 2021
72
82nd percentile among 6,253 codes billed · 2021
1,583
92nd percentile among 6,253 codes billed · 2021
+0.3%
Medicare payment on the code vs 2020; billers +49.7% · 2021

Trend

Medicare payment on the code

$0$20M2020: $18M paid20202021: $18M paid20212022: $17M paid20222023: $21M paid20232024: $30M paid2024$30M$0$20M2020: $18M paid20202021: $18M paid20212022: $17M paid20222023: $21M paid20232024: $30M paid2024$30M$0$20M2020: $18M paid20202021: $18M paid20212022: $17M paid20222023: $21M paid20232024: $30M paid2024$30M$0$20M2020: $18M paid20202021: $18M paid20212022: $17M paid20222023: $21M paid20232024: $30M paid2024$30M

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

Billers

05001,0002020: 784 providers20202021: 1,174 providers20212022: 1,286 providers20222023: 1,017 providers20232024: 1,107 providers20241,10705001,0002020: 784 providers20202021: 1,174 providers20212022: 1,286 providers20222023: 1,017 providers20232024: 1,107 providers20241,10705001,0002020: 784 providers20202021: 1,174 providers20212022: 1,286 providers20222023: 1,017 providers20232024: 1,107 providers20241,10705001,0002020: 784 providers20202021: 1,174 providers20212022: 1,286 providers20222023: 1,017 providers20232024: 1,107 providers20241,107

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
20241,107$29,980,573+43%872,8171004,0500.00
20231,017$20,992,298+20%611,353872,5500.00
20221,286$17,477,360-2%505,022701,6340.00
20211,174$17,835,286+0%508,952721,5830.00
2020784$17,785,193first year in data509,712702,3720.00

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
California97$3,227,83992,0251473,430
Texas145$2,813,86880,257881,427
South Carolina47$2,003,49757,12142220
Pennsylvania20$1,162,56533,1358211,070
Georgia55$999,79228,5111231,113
Alabama71$643,76718,39032850
Maryland35$640,56518,2721022,916
Indiana41$598,46117,06560418
Arizona63$568,43616,21175584
Oklahoma31$521,77514,8912511,795
New York69$423,31012,09148917
New Jersey30$423,18912,062711,783
Michigan44$352,22210,05088481
Florida35$350,0689,983851,045
Arkansas18$335,5999,610971,493

Not listed: 14 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, CA62$2,859,97081,537151
Dallas-Fort Worth-Arlington, TX58$1,563,41544,57888
Houston-Pasadena-The Woodlands, TX36$693,95319,786123
New York-Newark-Jersey City, NY-NJ87$666,33619,00248
Atlanta-Sandy Springs-Roswell, GA26$615,55817,545101
Phoenix-Mesa-Chandler, AZ56$528,28415,06673
Indianapolis-Carmel-Greenwood, IN14$519,89114,82564
Birmingham, AL25$477,27413,62225
Baltimore-Columbia-Towson, MD24$396,71811,321125
Detroit-Warren-Dearborn, MI40$336,2569,59588
Little Rock-North Little Rock-Conway, AR16$334,1529,567112
Washington-Arlington-Alexandria, DC-VA-MD-WV15$290,5788,292139
Oklahoma City, OK18$269,7057,704248
Las Vegas-Henderson-North Las Vegas, NV11$223,7636,38557
Raleigh-Cary, NC21$215,6036,14688

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 28 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 87640 nationally

Clinical Laboratory accounts for 74% of payment for 87640 nationally in 2021, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory25622%$13,160,78474%375,3691,466
Urology62954%$2,919,41616%83,390133
Pathology413.5%$1,139,7056.4%32,552794
Nurse Practitioner706.0%$157,7780.88%4,50764
Podiatry443.7%$111,0360.62%3,17172
Internal Medicine201.7%$96,0950.54%2,777139
Family Practice363.1%$79,7050.45%2,29564
Physician Assistant423.6%$66,2640.37%1,89545
Obstetrics & Gynecology131.1%$59,8540.34%1,712132

Not listed: 11 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 87640 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