HCPCS 88313

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

Laboratory Work RVU per service 0.24 (2024 fee schedule)

6,734
96th percentile among 6,471 codes billed · 2024
$48M
95th percentile among 6,471 codes billed · 2024
1.4M
96th percentile among 6,471 codes billed · 2024
69
78th percentile among 6,471 codes billed · 2024
666
81st percentile among 6,471 codes billed · 2024
-3.8%
Medicare payment on the code vs 2023; billers -0.3% · 2024

Trend

Medicare payment on the code

$0$20M$40M2020: $42M paid20202021: $51M paid20212022: $49M paid20222023: $50M paid20232024: $48M paid2024$48M$0$20M$40M2020: $42M paid20202021: $51M paid20212022: $49M paid20222023: $50M paid20232024: $48M paid2024$48M$0$20M$40M2020: $42M paid20202021: $51M paid20212022: $49M paid20222023: $50M paid20232024: $48M paid2024$48M$0$20M$40M2020: $42M paid20202021: $51M paid20212022: $49M paid20222023: $50M paid20232024: $48M paid2024$48M

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

Billers

05,0002020: 6,913 providers20202021: 7,009 providers20212022: 6,772 providers20222023: 6,757 providers20232024: 6,734 providers20246,73405,0002020: 6,913 providers20202021: 7,009 providers20212022: 6,772 providers20222023: 6,757 providers20232024: 6,734 providers20246,73405,0002020: 6,913 providers20202021: 7,009 providers20212022: 6,772 providers20222023: 6,757 providers20232024: 6,734 providers20246,73405,0002020: 6,913 providers20202021: 7,009 providers20212022: 6,772 providers20222023: 6,757 providers20232024: 6,734 providers20246,734

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
20246,734$48,256,766-4%1,394,911696660.24
20236,757$50,183,262+3%1,413,874666930.24
20226,772$48,948,709-5%1,391,247656940.24
20217,009$51,432,994+22%1,478,397676730.24
20206,913$42,330,684first year in data1,315,368656070.24

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
California654$5,743,950153,82577744
New York479$5,520,398134,798731,188
New Jersey190$5,385,454103,9701203,196
Florida482$4,890,086122,72284971
Maryland141$4,300,44977,453781,836
Texas553$3,698,750104,84472582
Georgia198$2,003,27952,905761,169
Arkansas101$1,878,64992,9672041,130
Pennsylvania294$1,696,60556,17560674
Arizona163$1,590,94942,396911,043
Tennessee200$1,376,88642,922601,103
Illinois280$1,185,66238,79961346
Connecticut109$1,120,85823,79378644
South Carolina109$935,14425,605103571
Massachusetts279$823,01135,30864346

Not listed: 1 billers with an armed-forces or unknown state code (AP); they are in the national totals.

Not listed: 3 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-NJ504$10,414,578219,786110
Washington-Arlington-Alexandria, DC-VA-MD-WV104$4,097,32778,06793
Los Angeles-Long Beach-Anaheim, CA260$3,261,30774,77690
Dallas-Fort Worth-Arlington, TX148$2,243,53452,20589
Little Rock-North Little Rock-Conway, AR79$1,782,46090,154297
Atlanta-Sandy Springs-Roswell, GA124$1,581,21937,77470
Phoenix-Mesa-Chandler, AZ124$1,216,22330,688101
Miami-Fort Lauderdale-West Palm Beach, FL133$1,187,55826,65279
Cape Coral-Fort Myers, FL25$1,057,80220,958143
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD161$1,011,49434,83277
Chicago-Naperville-Elgin, IL-IN247$980,18933,80165
Orlando-Kissimmee-Sanford, FL57$934,73820,202124
Houston-Pasadena-The Woodlands, TX202$856,46228,19271
Memphis, TN-MS-AR44$818,18716,84191
Boston-Cambridge-Newton, MA-NH229$757,70830,26562

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 78 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 88313 nationally

Pathology accounts for 59% of payment for 88313 nationally in 2024, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Pathology5,74085%$28,597,38959%973,458170
Clinical Laboratory3214.8%$14,461,59830%309,376964
Gastroenterology3545.3%$3,140,1416.5%69,103195
Dermatology1732.6%$944,2052.0%16,42095
Podiatry200.30%$629,2681.3%9,813491
Internal Medicine340.50%$205,6310.43%5,217153
Urology260.39%$168,2730.35%5,551214
Ophthalmology180.27%$25,6470.05%1,869104
Hematology-Oncology140.21%$15,0340.03%39528

Not listed: 14 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 88313 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