HCPCS 87811

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

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

8,790
97th percentile among 6,326 codes billed · 2022
$24M
93rd percentile among 6,326 codes billed · 2022
604K
94th percentile among 6,326 codes billed · 2022
31
60th percentile among 6,326 codes billed · 2022
184
68th percentile among 6,326 codes billed · 2022
+131.2%
Medicare payment on the code vs 2021; billers +83.6% · 2022

Trend

Medicare payment on the code

$0$20M2020: $116K paid20202021: $11M paid20212022: $24M paid20222023: $30M paid20232024: $32M paid2024$32M$0$20M2020: $116K paid20202021: $11M paid20212022: $24M paid20222023: $30M paid20232024: $32M paid2024$32M$0$20M2020: $116K paid20202021: $11M paid20212022: $24M paid20222023: $30M paid20232024: $32M paid2024$32M$0$20M2020: $116K paid20202021: $11M paid20212022: $24M paid20222023: $30M paid20232024: $32M paid2024$32M

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

Billers

05,00010K2020: 111 providers20202021: 4,787 providers20212022: 8,790 providers20222023: 10K providers20232024: 13K providers202413K05,00010K2020: 111 providers20202021: 4,787 providers20212022: 8,790 providers20222023: 10K providers20232024: 13K providers202413K05,00010K2020: 111 providers20202021: 4,787 providers20212022: 8,790 providers20222023: 10K providers20232024: 13K providers202413K05,00010K2020: 111 providers20202021: 4,787 providers20212022: 8,790 providers20222023: 10K providers20232024: 13K providers202413K

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
202412,806$31,519,685+4%783,946261080.00
202310,132$30,411,197+25%756,135271180.00
20228,790$24,393,052+131%603,628311840.00
20214,787$10,551,167+9011%257,603251320.00
2020111$115,809first year in data2,8121562

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
New York631$3,574,53987,55742386
California407$2,018,65849,70929387
Illinois420$1,917,21546,93532461
Florida498$1,665,94840,88140263
Texas695$1,548,57938,09732135
North Carolina426$1,296,37331,78031154
Alabama440$1,037,87926,42937156
Maryland236$1,015,48524,97458268
South Carolina264$942,82023,24445194
Tennessee519$936,36023,29728120
Louisiana384$861,77421,23938150
Pennsylvania355$776,98619,18928125
New Jersey269$747,18018,40435217
Georgia301$614,73015,33931149
Arkansas217$561,56713,87446158

Not listed: 2 billers with an armed-forces or unknown state code (AE, AP); they are in the national totals.

Not listed: 7 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
New York-Newark-Jersey City, NY-NJ729$3,911,19895,82242
Chicago-Naperville-Elgin, IL-IN403$1,898,45746,42634
Los Angeles-Long Beach-Anaheim, CA133$1,004,60524,70030
Baltimore-Columbia-Towson, MD132$566,23213,89378
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD178$477,82511,73734
Miami-Fort Lauderdale-West Palm Beach, FL94$473,60511,62542
Dallas-Fort Worth-Arlington, TX135$441,14810,79130
Washington-Arlington-Alexandria, DC-VA-MD-WV121$312,6957,68831
Columbia, SC30$280,5696,90235
Charlotte-Concord-Gastonia, NC-SC83$274,4646,72829
Greensboro-High Point, NC19$257,0686,29730
Tampa-St. Petersburg-Clearwater, FL100$223,0565,48532
El Centro, CA12$221,6135,416121
Little Rock-North Little Rock-Conway, AR82$218,7245,42150
Detroit-Warren-Dearborn, MI80$209,9755,18930

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 89 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 87811 nationally

Nurse Practitioner accounts for 29% of payment for 87811 nationally in 2022, across 15 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner3,27937%$7,011,45629%173,64553
Physician Assistant2,11524%$4,280,00018%105,36950
Family Practice1,80721%$4,263,40517%107,20359
Clinical Laboratory1491.7%$3,243,02813%79,457533
Internal Medicine8409.6%$2,446,81510%60,46372
Emergency Medicine2562.9%$1,569,3186.4%38,513150
Pediatric Medicine250.28%$251,6581.0%6,148246
General Practice710.81%$218,3360.90%5,54178
Pulmonary Disease380.43%$205,4660.84%5,053133
Gastroenterology250.28%$112,4730.46%2,751110
Otolaryngology120.14%$69,9480.29%1,722144
Hospitalist140.16%$49,1020.20%1,21187
Cardiology120.14%$36,7170.15%89875
Geriatric Medicine110.13%$20,1510.08%50246
Allergy/ Immunology110.13%$19,3390.08%47443

Not listed: 33 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 87811 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