HCPCS 87801

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

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

824
84th percentile among 6,253 codes billed · 2021
$46M
95th percentile among 6,253 codes billed · 2021
662K
94th percentile among 6,253 codes billed · 2021
167
91st percentile among 6,253 codes billed · 2021
3,040
95th percentile among 6,253 codes billed · 2021
+11.9%
Medicare payment on the code vs 2020; billers +41.8% · 2021

Trend

Medicare payment on the code

$0$20M$40M2020: $41M paid20202021: $46M paid20212022: $36M paid20222023: $37M paid20232024: $48M paid2024$48M$0$20M$40M2020: $41M paid20202021: $46M paid20212022: $36M paid20222023: $37M paid20232024: $48M paid2024$48M$0$20M$40M2020: $41M paid20202021: $46M paid20212022: $36M paid20222023: $37M paid20232024: $48M paid2024$48M$0$20M$40M2020: $41M paid20202021: $46M paid20212022: $36M paid20222023: $37M paid20232024: $48M paid2024$48M

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

Billers

05002020: 581 providers20202021: 824 providers20212022: 842 providers20222023: 561 providers20232024: 598 providers202459805002020: 581 providers20202021: 824 providers20212022: 842 providers20222023: 561 providers20232024: 598 providers202459805002020: 581 providers20202021: 824 providers20212022: 842 providers20222023: 561 providers20232024: 598 providers202459805002020: 581 providers20202021: 824 providers20212022: 842 providers20222023: 561 providers20232024: 598 providers2024598

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
2024598$48,225,071+30%702,2751724,1280.00
2023561$36,961,405+2%543,4731503,2790.00
2022842$36,154,012-22%524,2261442,1270.00
2021824$46,110,252+12%661,8901673,0400.00
2020581$41,202,130first year in data592,0371532,7180.00

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
Texas84$9,617,874137,1852584,980
California71$7,966,647113,5232644,720
Pennsylvania22$3,594,21351,21716213,240
Arizona60$2,564,43536,6702421,753
South Carolina39$2,512,97835,818126988
Georgia39$2,316,85133,0613062,835
Florida32$2,226,72631,7672674,515
North Carolina47$2,217,11431,6421501,780
Oklahoma17$2,028,94028,9767325,630
Massachusetts21$1,571,38222,4193154,037
New Jersey22$1,226,99817,5262003,088
Alabama48$1,126,10218,917651,522
New York44$762,26310,910231,656
Maryland11$692,2089,8875663,200
Virginia14$625,8158,9473542,321

Not listed: 15 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, CA30$6,156,98187,728282
Dallas-Fort Worth-Arlington, TX49$5,311,53775,726186
Houston-Pasadena-The Woodlands, TX23$3,216,43645,879484
Phoenix-Mesa-Chandler, AZ54$2,331,73433,352242
New York-Newark-Jersey City, NY-NJ39$1,625,60123,207111
Atlanta-Sandy Springs-Roswell, GA20$1,052,73215,00284
Birmingham, AL25$844,43914,80154
Riverside-San Bernardino-Ontario, CA12$790,49711,265615
Raleigh-Cary, NC21$678,0149,661264
Myrtle Beach-Conway-North Myrtle Beach, SC16$498,4907,101122
Chicago-Naperville-Elgin, IL-IN23$403,5645,765128
Louisville/Jefferson County, KY-IN28$399,9326,439188
Springfield, MA13$344,9634,920234
Charlotte-Concord-Gastonia, NC-SC15$335,8164,802186
Indianapolis-Carmel-Greenwood, IN15$250,6853,597195

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 2021.

Specialties billing 87801 nationally

Clinical Laboratory accounts for 64% of payment for 87801 nationally in 2021, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory18923%$29,346,76664%421,7542,232
Urology38747%$11,828,08426%169,527438
Pathology344.1%$2,655,3385.8%37,9521,116
Podiatry344.1%$634,8881.4%9,055266
Nurse Practitioner546.6%$482,2041.0%6,926128
Obstetrics & Gynecology485.8%$420,4590.91%6,008125
Family Practice273.3%$322,9250.70%4,632172
Physician Assistant323.9%$249,3030.54%3,569112

Not listed: 7 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 87801 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