HCPCS 87640

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

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

1,017
86th percentile among 6,405 codes billed · 2023
$21M
92nd percentile among 6,405 codes billed · 2023
611K
94th percentile among 6,405 codes billed · 2023
87
84th percentile among 6,405 codes billed · 2023
2,550
93rd percentile among 6,405 codes billed · 2023
+20.1%
Medicare payment on the code vs 2022; billers -20.9% · 2023

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
Texas253$6,543,894190,471732,559
California67$2,389,22069,4882714,713
Florida72$2,221,74264,7132102,103
Pennsylvania29$1,752,69950,9781418,609
Illinois54$797,48423,218792,305
Maryland50$793,61023,0901251,291
Oklahoma37$789,50722,9812163,530
Arkansas34$725,88221,187592,157
Louisiana20$685,22920,1461238,027
New Jersey32$591,72917,2291362,921
New York21$587,54817,121734,226
Mississippi52$541,49815,78591984
Virginia26$326,7649,507801,456
Colorado49$247,9757,21327850
Massachusetts45$207,1236,024114374

Not listed: 21 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
Dallas-Fort Worth-Arlington, TX109$4,439,024129,16871
Los Angeles-Long Beach-Anaheim, CA53$2,110,30961,376387
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD23$1,414,39141,13690
Houston-Pasadena-The Woodlands, TX47$1,334,92038,885150
New York-Newark-Jersey City, NY-NJ45$966,72928,144106
Little Rock-North Little Rock-Conway, AR29$617,21118,02378
Chicago-Naperville-Elgin, IL-IN45$609,99017,75159
Washington-Arlington-Alexandria, DC-VA-MD-WV23$492,07414,31264
Oklahoma City, OK22$483,16614,072229
Baltimore-Columbia-Towson, MD35$473,76913,787140
San Antonio-New Braunfels, TX57$379,45411,05681
Miami-Fort Lauderdale-West Palm Beach, FL13$217,7576,332250
Memphis, TN-MS-AR18$210,3746,126112
Pensacola-Ferry Pass-Brent, FL14$169,0094,916156
Colorado Springs, CO12$106,3033,09324

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 21 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 87640 nationally

Clinical Laboratory accounts for 81% of payment for 87640 nationally in 2023, across 7 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory34734%$17,099,10281%497,8411,435
Urology41040%$2,101,22510%61,274149
Pathology343.3%$1,038,5944.9%30,259890
Podiatry555.4%$253,3501.2%7,369134
Nurse Practitioner787.7%$235,1941.1%6,86488
Physician Assistant444.3%$107,9400.51%3,14471
Internal Medicine131.3%$52,4090.25%1,552119

Not listed: 10 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 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