HCPCS 87798

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

Laboratory Work RVU per service none (2020 fee schedule; adds 0 work RVUs)

1,132
86th percentile among 6,116 codes billed · 2020
$180M
99th percentile among 6,116 codes billed · 2020
5.2M
99th percentile among 6,116 codes billed · 2020
416
95th percentile among 6,116 codes billed · 2020
16,191
98th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$200M$400M2020: $180M paid20202021: $209M paid20212022: $220M paid20222023: $289M paid20232024: $437M paid2024$437M$0$200M$400M2020: $180M paid20202021: $209M paid20212022: $220M paid20222023: $289M paid20232024: $437M paid2024$437M$0$200M$400M2020: $180M paid20202021: $209M paid20212022: $220M paid20222023: $289M paid20232024: $437M paid2024$437M$0$200M$400M2020: $180M paid20202021: $209M paid20212022: $220M paid20222023: $289M paid20232024: $437M paid2024$437M

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

Billers

01,0002020: 1,132 providers20202021: 1,474 providers20212022: 1,607 providers20222023: 1,319 providers20232024: 1,416 providers20241,41601,0002020: 1,132 providers20202021: 1,474 providers20212022: 1,607 providers20222023: 1,319 providers20232024: 1,416 providers20241,41601,0002020: 1,132 providers20202021: 1,474 providers20212022: 1,607 providers20222023: 1,319 providers20232024: 1,416 providers20241,41601,0002020: 1,132 providers20202021: 1,474 providers20212022: 1,607 providers20222023: 1,319 providers20232024: 1,416 providers20241,416

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
20241,416$436,743,071+51%12,712,40883247,0090.00
20231,319$288,642,194+31%8,402,62262227,9020.00
20221,607$220,440,407+6%6,369,88063116,4140.00
20211,474$208,687,218+16%5,957,72456013,8870.00
20201,132$179,574,634first year in data5,158,97141616,1910.00

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
California112$49,609,0141,422,5881,20052,098
Georgia43$15,500,049444,9301,49637,453
Missouri12$15,054,556431,701633188,730
South Carolina36$11,606,894332,5817874,186
Arizona44$9,699,746277,37073117,010
Alabama44$9,479,694280,33340043,327
Pennsylvania24$8,918,032255,14729274,222
Texas133$6,628,270189,8341404,824
Indiana44$5,320,075152,7989517,540
North Carolina41$5,089,858146,2841564,776
Michigan50$4,870,706139,5476554,652
New Jersey50$3,607,885103,49525013,421
New York101$3,196,15492,0225702,809
Virginia18$2,748,16879,01125028,890
Illinois42$2,703,71077,9148469,818

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 2020.

Top metro areas

observed calculated calculated calculated calculated
Los Angeles-Long Beach-Anaheim, CA71$46,428,3751,331,3793,327
Atlanta-Sandy Springs-Roswell, GA25$12,607,263361,7543,172
Phoenix-Mesa-Chandler, AZ39$9,424,431269,470679
Birmingham, AL18$6,153,575177,261613
New York-Newark-Jersey City, NY-NJ143$5,742,795165,099436
Detroit-Warren-Dearborn, MI46$4,790,785137,264676
Dallas-Fort Worth-Arlington, TX65$4,301,429123,116168
Indianapolis-Carmel-Greenwood, IN14$3,651,344104,719870
Raleigh-Cary, NC11$2,594,79474,569221
Chicago-Naperville-Elgin, IL-IN35$1,969,52856,809897
Louisville/Jefferson County, KY-IN34$1,862,83353,510951
Houston-Pasadena-The Woodlands, TX31$1,676,00348,023201
Washington-Arlington-Alexandria, DC-VA-MD-WV17$1,418,66040,593282
Baltimore-Columbia-Towson, MD21$876,07225,211210
Myrtle Beach-Conway-North Myrtle Beach, SC18$741,08021,237943

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 2020.

Specialties billing 87798 nationally

Clinical Laboratory accounts for 86% of payment for 87798 nationally in 2020, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory44940%$153,887,09786%4,420,3969,845
Urology40536%$13,423,4327.5%385,912953
Pathology605.3%$9,027,6505.0%259,5964,327
Podiatry201.8%$852,1040.47%24,4371,222
Internal Medicine494.3%$774,0250.43%22,387457
Family Practice675.9%$620,9720.35%17,879267
Nurse Practitioner322.8%$451,3040.25%12,909403
Obstetrics & Gynecology121.1%$169,7980.09%4,868406
Physician Assistant141.2%$59,5600.03%1,701122

Not listed: 13 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 87798 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