HCPCS 88120

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

Laboratory Work RVU per service 1.20 (2022 fee schedule)

225
74th percentile among 6,326 codes billed · 2022
$23M
93rd percentile among 6,326 codes billed · 2022
59K
82nd percentile among 6,326 codes billed · 2022
78
83rd percentile among 6,326 codes billed · 2022
1,139
89th percentile among 6,326 codes billed · 2022
-5.1%
Medicare payment on the code vs 2021; billers -1.7% · 2022

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 Jersey20$5,092,52413,7012361,663
New York33$4,525,0479,3121171,339
California18$2,526,9695,7371251,233
Florida11$1,822,0954,4201551,463
Texas14$1,813,7224,053891,311
Massachusetts24$1,615,0724,883102493
Illinois11$499,7141,27542489
Pennsylvania16$188,8461,82824461

Not listed: 23 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-NJ51$9,531,76622,748128
Los Angeles-Long Beach-Anaheim, CA12$1,975,0324,277159
Springfield, MA12$512,0961,57293
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD15$187,8001,80423

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 2022.

Specialties billing 88120 nationally

Pathology accounts for 61% of payment for 88120 nationally in 2022, across 3 specialties on claims.

observed calculated calculated calculated calculated calculated
Pathology12254%$14,072,77261%37,397307
Clinical Laboratory5524%$8,026,03535%17,483318
Urology4821%$1,107,1574.8%3,89681

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 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