HCPCS 87640

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

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

1,286
87th percentile among 6,326 codes billed · 2022
$17M
91st percentile among 6,326 codes billed · 2022
505K
93rd percentile among 6,326 codes billed · 2022
70
82nd percentile among 6,326 codes billed · 2022
1,634
92nd percentile among 6,326 codes billed · 2022
-2.0%
Medicare payment on the code vs 2021; billers +9.5% · 2022

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
Texas203$3,117,29790,294931,262
California106$2,858,31282,3531424,186
Pennsylvania29$1,953,00456,49416210,236
Florida56$928,45826,8521512,528
Oklahoma35$829,85724,0232433,364
Maryland42$808,46223,3561542,615
South Carolina21$670,88519,177371,814
Alabama44$647,08318,688722,689
New York52$566,12716,384392,147
Arizona62$472,90213,59796424
Arkansas20$439,62312,729107878
Indiana34$435,49812,54043191
New Jersey24$432,07412,4931572,284
Illinois47$379,64510,985621,080
Massachusetts47$286,6498,275133406

Not listed: 13 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, CA64$2,450,69170,624190
Dallas-Fort Worth-Arlington, TX80$1,948,81756,45266
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD20$1,792,76451,85873
New York-Newark-Jersey City, NY-NJ65$774,88122,40948
Houston-Pasadena-The Woodlands, TX48$662,58619,172104
Oklahoma City, OK22$505,01814,630256
Birmingham, AL15$492,13314,20156
Washington-Arlington-Alexandria, DC-VA-MD-WV15$486,20114,049117
Little Rock-North Little Rock-Conway, AR17$429,85312,445104
Phoenix-Mesa-Chandler, AZ57$426,93612,27084
Baltimore-Columbia-Towson, MD30$414,48411,972154
San Antonio-New Braunfels, TX46$259,0817,511114
Chicago-Naperville-Elgin, IL-IN38$240,3236,95461
Raleigh-Cary, NC12$212,9986,14929
Las Vegas-Henderson-North Las Vegas, NV16$174,9355,01831

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 2022.

Specialties billing 87640 nationally

Clinical Laboratory accounts for 74% of payment for 87640 nationally in 2022, across 10 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory30624%$12,850,91374%371,3281,213
Urology63149%$2,734,48416%78,983125
Pathology453.5%$1,059,0936.1%30,590680
Podiatry645.0%$240,8931.4%6,960109
Nurse Practitioner806.2%$190,1681.1%5,49969
Physician Assistant493.8%$99,7030.57%2,88159
Internal Medicine272.1%$98,0370.56%2,868106
Family Practice282.2%$78,5970.45%2,28982
Obstetrics & Gynecology161.2%$65,6880.38%1,893118
Hematology-Oncology110.86%$9,5870.05%27825

Not listed: 14 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 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