HCPCS 87801

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

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

561
82nd percentile among 6,405 codes billed · 2023
$37M
95th percentile among 6,405 codes billed · 2023
543K
93rd percentile among 6,405 codes billed · 2023
150
89th percentile among 6,405 codes billed · 2023
3,279
95th percentile among 6,405 codes billed · 2023
+2.2%
Medicare payment on the code vs 2022; billers -33.4% · 2023

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
Florida63$10,487,093152,7084535,750
Texas117$10,118,832152,4271654,914
Oklahoma21$3,115,85545,33763613,986
Colorado24$1,900,12627,751702,582
New York24$1,803,14526,295573,727
New Jersey23$1,621,71323,6313005,528
Illinois29$1,512,90022,0171243,492
California30$1,495,76421,7571743,363
Mississippi30$891,53913,0352941,047
Massachusetts35$849,13912,3531201,333
Maryland24$833,71212,1331441,360
Pennsylvania26$786,92011,4493051,057
Virginia14$164,3792,391140431

Not listed: 25 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
Houston-Pasadena-The Woodlands, TX21$6,707,008102,621399
Tampa-St. Petersburg-Clearwater, FL11$4,413,94164,173933
New York-Newark-Jersey City, NY-NJ39$2,955,37343,065126
Dallas-Fort Worth-Arlington, TX65$2,167,25731,615138
Oklahoma City, OK13$1,780,26325,917648
Denver-Aurora-Centennial, CO13$1,686,26224,52761
Chicago-Naperville-Elgin, IL-IN27$1,431,05320,816118
Pensacola-Ferry Pass-Brent, FL14$1,017,13914,787467
Los Angeles-Long Beach-Anaheim, CA14$986,23814,337226
Baltimore-Columbia-Towson, MD14$736,74210,720306
Boston-Cambridge-Newton, MA-NH16$643,0509,35287
Jackson, MS12$259,8253,787213
Jacksonville, FL12$245,2893,63543
Tupelo, MS12$243,4873,594282
San Antonio-New Braunfels, TX11$204,0852,983165

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 18 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 87801 nationally

Clinical Laboratory accounts for 70% of payment for 87801 nationally in 2023, across 7 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory18032%$26,005,11570%383,5412,131
Urology21739%$5,986,63916%87,336402
Pathology264.6%$2,882,2847.8%41,9911,615
Nurse Practitioner386.8%$833,8842.3%12,236322
Podiatry417.3%$564,0291.5%8,281202
Physician Assistant183.2%$370,4281.0%5,421301
Obstetrics & Gynecology213.7%$96,0360.26%1,40867

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 2023.

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