HCPCS 87801

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

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

842
84th percentile among 6,326 codes billed · 2022
$36M
95th percentile among 6,326 codes billed · 2022
524K
93rd percentile among 6,326 codes billed · 2022
144
90th percentile among 6,326 codes billed · 2022
2,127
93rd percentile among 6,326 codes billed · 2022
-21.6%
Medicare payment on the code vs 2021; billers +2.2% · 2022

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
Texas110$7,917,458115,1632183,745
Florida52$4,821,29169,6652255,546
California64$4,547,39465,2172642,210
Oklahoma25$3,678,03653,2474629,065
Massachusetts41$1,693,54424,4683631,438
New York75$1,601,64023,19048878
New Jersey19$1,566,05322,6664354,773
Pennsylvania25$1,366,37719,7192123,512
Arizona48$1,328,03619,071216961
Illinois32$931,62713,4771491,584
Maryland19$740,79610,7171651,483
North Carolina23$711,77210,196722,295
Colorado37$639,0139,385119740
Georgia34$542,7617,797101816
Nevada13$497,9357,136692,594

Not listed: 18 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
Houston-Pasadena-The Woodlands, TX24$4,970,47772,216334
Los Angeles-Long Beach-Anaheim, CA24$3,301,02147,374293
New York-Newark-Jersey City, NY-NJ68$2,541,81236,77378
Oklahoma City, OK16$2,218,69932,167390
Dallas-Fort Worth-Arlington, TX66$2,036,37129,436196
Phoenix-Mesa-Chandler, AZ43$1,167,96816,775204
Boston-Cambridge-Newton, MA-NH16$1,070,26015,475462
Pensacola-Ferry Pass-Brent, FL13$891,10712,887309
Chicago-Naperville-Elgin, IL-IN28$719,53410,422122
Baltimore-Columbia-Towson, MD11$628,4189,093405
Las Vegas-Henderson-North Las Vegas, NV13$497,9357,13669
Riverside-San Bernardino-Ontario, CA13$473,2626,762447
Birmingham, AL12$356,3636,66061
Louisville/Jefferson County, KY-IN30$353,1785,050127
Springfield, MA14$324,0694,668340

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 2022.

Specialties billing 87801 nationally

Clinical Laboratory accounts for 59% of payment for 87801 nationally in 2022, across 10 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory17921%$21,425,77659%311,5371,740
Urology40148%$9,589,38327%138,237345
Pathology253.0%$2,684,5577.4%38,7981,552
Podiatry536.3%$706,9782.0%10,240193
Nurse Practitioner475.6%$567,3421.6%8,259176
Physician Assistant374.4%$418,3571.2%6,081164
Obstetrics & Gynecology414.9%$354,9610.98%5,133125
Family Practice172.0%$189,2950.52%2,719160
Internal Medicine131.5%$80,1630.22%1,20693
Hematology-Oncology111.3%$55,6240.15%80773

Not listed: 12 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 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