HCPCS 88305

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

Laboratory Work RVU per service 0.75 (2021 fee schedule)

14,708
98th percentile among 6,253 codes billed · 2021
$722M
100th percentile among 6,253 codes billed · 2021
18.4M
100th percentile among 6,253 codes billed · 2021
516
95th percentile among 6,253 codes billed · 2021
4,127
96th percentile among 6,253 codes billed · 2021
+10.4%
Medicare payment on the code vs 2020; billers -0.6% · 2021

Trend

Medicare payment on the code

$0$500M2020: $654M paid20202021: $722M paid20212022: $707M paid20222023: $711M paid20232024: $708M paid2024$708M$0$500M2020: $654M paid20202021: $722M paid20212022: $707M paid20222023: $711M paid20232024: $708M paid2024$708M$0$500M2020: $654M paid20202021: $722M paid20212022: $707M paid20222023: $711M paid20232024: $708M paid2024$708M$0$500M2020: $654M paid20202021: $722M paid20212022: $707M paid20222023: $711M paid20232024: $708M paid2024$708M

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

Billers

010K2020: 15K providers20202021: 15K providers20212022: 15K providers20222023: 15K providers20232024: 15K providers202415K010K2020: 15K providers20202021: 15K providers20212022: 15K providers20222023: 15K providers20232024: 15K providers202415K010K2020: 15K providers20202021: 15K providers20212022: 15K providers20222023: 15K providers20232024: 15K providers202415K010K2020: 15K providers20202021: 15K providers20212022: 15K providers20222023: 15K providers20232024: 15K providers202415K

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
202414,573$707,769,609-0%18,351,5514904,4690.75
202314,580$710,512,703+0%18,319,9904894,3960.75
202214,626$707,366,234-2%18,119,1684944,2980.75
202114,708$722,157,640+10%18,432,7555164,1270.75
202014,801$654,091,212first year in data16,814,8604723,6700.75

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
Florida1,022$84,415,7692,038,8286018,703
California1,597$79,175,3811,853,3784534,218
Texas1,112$59,737,0841,466,1964044,019
New York993$58,784,9551,246,3553964,242
Pennsylvania627$28,962,188737,6225442,968
Massachusetts501$26,712,701639,3245683,283
Ohio605$23,654,902639,6304502,956
Georgia353$23,031,647543,2055945,726
Illinois609$22,921,525633,3506412,880
Tennessee418$22,717,212647,2005895,913
North Carolina430$22,666,176565,8735364,699
New Jersey297$20,298,772491,6456516,729
Arizona253$17,759,101411,1136576,589
Maryland273$16,939,524378,3345383,375
Virginia261$14,434,464392,6288794,157

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

Not listed: 1 state 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ914$67,644,1621,423,353438
Los Angeles-Long Beach-Anaheim, CA695$33,001,718772,997410
Miami-Fort Lauderdale-West Palm Beach, FL280$32,376,888729,306462
Dallas-Fort Worth-Arlington, TX265$30,673,212702,554461
Boston-Cambridge-Newton, MA-NH392$23,701,457564,592548
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD324$19,629,290461,940547
Chicago-Naperville-Elgin, IL-IN496$18,992,067522,544598
Atlanta-Sandy Springs-Roswell, GA202$17,890,069393,637559
Washington-Arlington-Alexandria, DC-VA-MD-WV197$14,570,492329,396566
Phoenix-Mesa-Chandler, AZ179$12,660,469294,422717
Tampa-St. Petersburg-Clearwater, FL195$11,724,523285,889505
San Francisco-Oakland-Fremont, CA179$10,626,625225,616328
Birmingham, AL106$10,176,178231,549516
Houston-Pasadena-The Woodlands, TX412$10,133,133256,761285
Orlando-Kissimmee-Sanford, FL100$9,834,258237,429891

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 2021.

Specialties billing 88305 nationally

Pathology accounts for 57% of payment for 88305 nationally in 2021, across 15 specialties on claims.

observed calculated calculated calculated calculated calculated
Pathology10,75573%$412,487,38157%11,093,1671,031
Clinical Laboratory5593.8%$190,446,61726%4,308,4427,707
Dermatology1,81512%$98,899,06714%2,373,3631,308
Gastroenterology1,0407.1%$11,195,9921.6%388,691374
Micrographic Dermatologic Surgery430.29%$1,563,3570.22%43,1561,004
Internal Medicine610.41%$865,3560.12%22,590370
Oral Surgery (Dentist only)470.32%$542,7720.08%13,067278
Physician Assistant730.50%$456,8380.06%17,610241
Podiatry260.18%$408,0280.06%7,463287
Urology650.44%$361,5240.05%11,323174
Nurse Practitioner500.34%$320,7230.04%12,739255
Family Practice250.17%$222,5090.03%5,354214
Colorectal Surgery (Proctology)150.10%$137,1860.02%5,260351
Ophthalmology210.14%$75,6090.01%2,204105
Neurology210.14%$43,567<0.01%1,27361

Not listed: 21 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 2021.

Top billers of 88305 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