HCPCS 87811

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

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

10,132
97th percentile among 6,405 codes billed · 2023
$30M
94th percentile among 6,405 codes billed · 2023
756K
95th percentile among 6,405 codes billed · 2023
27
55th percentile among 6,405 codes billed · 2023
118
58th percentile among 6,405 codes billed · 2023
+24.7%
Medicare payment on the code vs 2022; billers +15.3% · 2023

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 York610$8,758,983216,08239187
California420$4,388,060108,86027214
Illinois369$1,822,12645,01626166
Texas824$1,366,14434,5912491
Tennessee759$1,215,89430,32329102
Florida606$1,153,39628,52227123
Alabama505$977,42125,23428155
Louisiana504$860,11221,4523299
Maryland257$845,42020,97349215
North Carolina440$805,82819,98626101
South Carolina273$662,54016,53031161
Pennsylvania516$643,73315,9872172
New Jersey304$629,14415,59733165
Washington55$540,70813,3461676
Georgia327$527,24513,22425104

Not listed: 3 billers with an armed-forces or unknown state code (AE, AP); they are in the national totals.

Not listed: 9 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
New York-Newark-Jersey City, NY-NJ744$9,068,703223,75838
Chicago-Naperville-Elgin, IL-IN372$1,826,80845,12927
Los Angeles-Long Beach-Anaheim, CA181$914,47322,57427
Seattle-Tacoma-Bellevue, WA25$514,41312,69517
Dallas-Fort Worth-Arlington, TX155$481,29211,91425
San Francisco-Oakland-Fremont, CA13$480,88511,86088
Baltimore-Columbia-Towson, MD133$432,29910,69864
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD220$327,5828,10524
Washington-Arlington-Alexandria, DC-VA-MD-WV187$315,9827,85426
Tampa-St. Petersburg-Clearwater, FL127$248,8446,14226
Knoxville, TN138$245,2016,11828
Miami-Fort Lauderdale-West Palm Beach, FL108$239,1805,90327
Oklahoma City, OK122$231,0495,76532
Memphis, TN-MS-AR99$223,3965,58931
Detroit-Warren-Dearborn, MI103$219,6265,52520

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 93 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 87811 nationally

Clinical Laboratory accounts for 43% of payment for 87811 nationally in 2023, across 13 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory820.81%$13,153,44143%324,4663,957
Nurse Practitioner4,24642%$6,820,51522%170,05140
Physician Assistant2,43424%$3,749,13312%92,99538
Family Practice1,89719%$3,185,58610%81,07243
Internal Medicine8788.7%$1,862,6036.1%46,60353
Emergency Medicine3513.5%$851,3752.8%21,18760
General Practice700.69%$144,1690.47%3,77554
Pulmonary Disease210.21%$111,8370.37%2,760131
Pediatric Medicine220.22%$41,6970.14%1,03247
Hospitalist150.15%$22,8440.08%56938
Allergy/ Immunology110.11%$22,0000.07%54650
Geriatric Medicine120.12%$19,2490.06%47840
General Surgery120.12%$17,1450.06%43136

Not listed: 36 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 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