HCPCS 87798

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

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

1,474
88th percentile among 6,253 codes billed · 2021
$209M
99th percentile among 6,253 codes billed · 2021
6.0M
99th percentile among 6,253 codes billed · 2021
560
95th percentile among 6,253 codes billed · 2021
13,887
98th percentile among 6,253 codes billed · 2021
+16.2%
Medicare payment on the code vs 2020; billers +30.2% · 2021

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
California141$59,091,7041,684,6981,23546,124
South Carolina43$15,943,345454,3935722,955
Georgia68$14,961,701426,7921,27518,803
Texas172$13,577,787387,51730310,883
Pennsylvania27$10,293,572293,36249068,134
Alabama89$10,281,522296,16531210,839
Indiana47$9,347,959266,5661,0755,690
Arizona71$7,668,919219,0857527,625
New Jersey39$7,243,317206,51175024,481
North Carolina60$6,185,315176,3796198,788
New York87$5,827,157166,51761110,081
Michigan52$4,625,217131,9148524,286
Illinois52$4,496,086128,53579312,519
Maryland41$4,425,683126,34128714,012
Nevada15$3,448,40198,40623730,684

Not listed: 16 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, CA90$52,758,1761,504,1641,372
New York-Newark-Jersey City, NY-NJ114$10,320,914294,442605
Atlanta-Sandy Springs-Roswell, GA37$9,521,486271,506406
Birmingham, AL32$7,442,700212,538317
Phoenix-Mesa-Chandler, AZ64$7,423,512212,087766
Indianapolis-Carmel-Greenwood, IN15$7,249,332206,699811
Houston-Pasadena-The Woodlands, TX42$5,793,513165,224872
Dallas-Fort Worth-Arlington, TX71$5,625,705160,668330
Detroit-Warren-Dearborn, MI47$4,439,416126,619858
Washington-Arlington-Alexandria, DC-VA-MD-WV20$3,562,315101,6891,055
Chicago-Naperville-Elgin, IL-IN45$2,897,86682,868793
Raleigh-Cary, NC19$2,775,16879,0971,191
Louisville/Jefferson County, KY-IN35$2,667,33076,0971,959
Richmond, VA12$2,537,53972,4242,406
Oklahoma City, OK21$2,356,76467,375807

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 33 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 87798 nationally

Clinical Laboratory accounts for 73% of payment for 87798 nationally in 2021, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory44230%$153,371,05173%4,377,8029,905
Urology62943%$30,131,44714%860,6551,368
Pathology624.2%$16,719,2458.0%477,3187,699
Podiatry745.0%$3,403,7401.6%97,1081,312
Nurse Practitioner825.6%$1,301,8720.62%37,185453
Internal Medicine463.1%$1,070,8370.51%30,791669
Family Practice704.7%$983,7700.47%28,155402
Obstetrics & Gynecology201.4%$833,0460.40%23,7911,190
Physician Assistant302.0%$482,9280.23%13,789460

Not listed: 8 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 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