HCPCS 88120

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

Laboratory Work RVU per service 1.20 (2024 fee schedule)

242
75th percentile among 6,471 codes billed · 2024
$20M
92nd percentile among 6,471 codes billed · 2024
54K
81st percentile among 6,471 codes billed · 2024
68
78th percentile among 6,471 codes billed · 2024
999
85th percentile among 6,471 codes billed · 2024
-9.9%
Medicare payment on the code vs 2023; billers +4.3% · 2024

Trend

Medicare payment on the code

$0$10M$20M2020: $20M paid20202021: $24M paid20212022: $23M paid20222023: $22M paid20232024: $20M paid2024$20M$0$10M$20M2020: $20M paid20202021: $24M paid20212022: $23M paid20222023: $22M paid20232024: $20M paid2024$20M$0$10M$20M2020: $20M paid20202021: $24M paid20212022: $23M paid20222023: $22M paid20232024: $20M paid2024$20M$0$10M$20M2020: $20M paid20202021: $24M paid20212022: $23M paid20222023: $22M paid20232024: $20M paid2024$20M

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

Billers

01002002020: 223 providers20202021: 229 providers20212022: 225 providers20222023: 232 providers20232024: 242 providers202424201002002020: 223 providers20202021: 229 providers20212022: 225 providers20222023: 232 providers20232024: 242 providers202424201002002020: 223 providers20202021: 229 providers20212022: 225 providers20222023: 232 providers20232024: 242 providers202424201002002020: 223 providers20202021: 229 providers20212022: 225 providers20222023: 232 providers20232024: 242 providers2024242

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
2024242$19,896,054-10%53,969689991.20
2023232$22,090,507-5%59,549719271.20
2022225$23,205,964-5%58,776781,1391.20
2021229$24,444,203+19%55,870671,1601.20
2020223$20,484,885first year in data51,560741,1191.20

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 Jersey22$3,948,6909,0371691,156
California17$2,205,3145,367571,384
New York33$2,053,5976,23478644
Pennsylvania13$1,894,6394,913192,087
Massachusetts30$1,487,5184,45686369
Texas19$1,286,9633,59169512
Florida18$1,047,2053,18344557
Arizona13$510,5601,91341647

Not listed: 22 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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ51$5,981,51814,985111
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD12$1,741,3464,68319
Springfield, MA16$594,2811,962107
Phoenix-Mesa-Chandler, AZ12$351,4381,07640

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 4 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2024.

Specialties billing 88120 nationally

Pathology accounts for 53% of payment for 88120 nationally in 2024, across 2 specialties on claims.

observed calculated calculated calculated calculated calculated
Pathology13455%$10,540,70253%29,000216
Clinical Laboratory5623%$7,678,40639%18,790336

Not listed: 2 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 2024.

Top billers of 88120 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