HCPCS 87798

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

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

1,319
88th percentile among 6,405 codes billed · 2023
$289M
99th percentile among 6,405 codes billed · 2023
8.4M
99th percentile among 6,405 codes billed · 2023
622
95th percentile among 6,405 codes billed · 2023
27,902
99th percentile among 6,405 codes billed · 2023
+30.9%
Medicare payment on the code vs 2022; billers -17.9% · 2023

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
Texas302$80,055,6062,329,92379028,485
Pennsylvania37$40,753,5351,185,2411,248104,154
California110$37,206,8191,082,3201,33545,024
Florida105$22,948,722668,81958617,199
Illinois69$11,888,552346,12475430,682
New Jersey40$11,370,994330,9251,75642,330
Maryland63$10,727,102312,1991,43013,405
New York40$8,732,849254,39774344,346
Louisiana23$8,103,021235,6581,39180,019
Oklahoma40$7,547,759219,6991,09443,072
Mississippi52$7,535,542220,2361,04715,293
Colorado54$6,074,534176,69134510,618
Virginia32$5,093,883148,17269030,091
Arkansas33$4,335,197126,30012227,450
Massachusetts50$3,086,14189,8391,1315,123

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, TX132$47,751,9791,389,633488
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD26$36,188,6401,052,441724
Los Angeles-Long Beach-Anaheim, CA73$33,297,723968,5753,522
Houston-Pasadena-The Woodlands, TX58$22,234,567647,0051,704
New York-Newark-Jersey City, NY-NJ72$16,894,539491,741962
Chicago-Naperville-Elgin, IL-IN59$9,268,779269,734611
Washington-Arlington-Alexandria, DC-VA-MD-WV31$6,673,225194,129832
Baltimore-Columbia-Towson, MD41$6,531,788190,1451,755
Oklahoma City, OK24$5,281,279153,7381,123
San Antonio-New Braunfels, TX62$5,198,023151,4361,013
Denver-Aurora-Centennial, CO29$4,151,646120,749312
Little Rock-North Little Rock-Conway, AR29$2,971,35586,600152
Miami-Fort Lauderdale-West Palm Beach, FL21$2,934,10285,4071,076
Memphis, TN-MS-AR17$2,828,79682,981116
Richmond, VA11$2,410,50170,1221,455

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 27 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 87798 nationally

Clinical Laboratory accounts for 84% of payment for 87798 nationally in 2023, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory52240%$243,667,05284%7,089,74313,582
Urology42032%$20,367,2437.1%593,8451,414
Pathology493.7%$14,560,0105.0%426,3178,700
Podiatry866.5%$4,591,5911.6%133,5911,553
Nurse Practitioner866.5%$2,320,9240.80%67,765788
Physician Assistant534.0%$855,4060.30%24,916470
Internal Medicine312.4%$764,5220.26%22,255718
Family Practice372.8%$545,6580.19%15,884429
Obstetrics & Gynecology130.99%$494,9200.17%14,4551,112

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 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