HCPCS 87798

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

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

1,607
89th percentile among 6,326 codes billed · 2022
$220M
99th percentile among 6,326 codes billed · 2022
6.4M
99th percentile among 6,326 codes billed · 2022
631
95th percentile among 6,326 codes billed · 2022
16,414
98th percentile among 6,326 codes billed · 2022
+5.6%
Medicare payment on the code vs 2021; billers +9.0% · 2022

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
California147$47,069,2741,356,2191,19536,579
Texas255$30,828,447893,62259712,896
Pennsylvania37$24,568,754711,4301,00158,451
Alabama60$9,480,439275,41154214,826
New Jersey34$9,254,746267,3602,28837,011
Maryland48$9,188,674265,9191,21330,168
New York74$8,085,439233,94344614,578
South Carolina24$7,639,863218,53841621,701
Arizona71$7,376,261212,7428585,260
Oklahoma38$6,808,682197,26481417,261
Indiana37$5,701,514164,1484852,016
Florida88$5,699,745164,7574768,492
Illinois58$5,120,631148,18674113,349
Georgia60$4,878,321140,1085079,372
Virginia31$4,303,939124,24494915,420

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 2022.

Top metro areas

observed calculated calculated calculated calculated
Los Angeles-Long Beach-Anaheim, CA86$41,629,6171,199,6782,311
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD22$22,560,268653,351694
Dallas-Fort Worth-Arlington, TX100$14,052,586407,810423
New York-Newark-Jersey City, NY-NJ96$13,587,190392,677504
Houston-Pasadena-The Woodlands, TX64$11,156,234322,703894
Birmingham, AL24$7,132,570205,921350
Phoenix-Mesa-Chandler, AZ66$6,994,757201,712838
Washington-Arlington-Alexandria, DC-VA-MD-WV20$6,473,277187,1631,137
Oklahoma City, OK25$6,307,312182,797957
Baltimore-Columbia-Towson, MD33$3,977,963115,3191,243
Atlanta-Sandy Springs-Roswell, GA31$3,476,59099,893536
Chicago-Naperville-Elgin, IL-IN48$3,299,10295,510715
San Antonio-New Braunfels, TX50$3,073,92289,315664
Richmond, VA13$2,722,27578,4763,835
Las Vegas-Henderson-North Las Vegas, NV19$2,464,77270,762186

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 31 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 87798 nationally

Clinical Laboratory accounts for 75% of payment for 87798 nationally in 2022, across 10 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory49731%$164,958,21675%4,767,9339,593
Urology63339%$27,234,29712%786,2351,242
Pathology573.5%$15,156,7906.9%437,5047,676
Podiatry1187.3%$6,775,5363.1%195,6311,658
Nurse Practitioner875.4%$1,638,5150.74%47,370544
Internal Medicine493.0%$1,232,5680.56%35,611727
Family Practice553.4%$1,112,4510.50%32,286587
Physician Assistant503.1%$978,3690.44%28,310566
Obstetrics & Gynecology221.4%$832,0490.38%23,9571,089
Hematology-Oncology120.75%$118,8500.05%3,450288

Not listed: 16 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 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