HCPCS 88313

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

Laboratory Work RVU per service 0.24 (2021 fee schedule)

7,009
96th percentile among 6,253 codes billed · 2021
$51M
96th percentile among 6,253 codes billed · 2021
1.5M
96th percentile among 6,253 codes billed · 2021
67
81st percentile among 6,253 codes billed · 2021
673
84th percentile among 6,253 codes billed · 2021
+21.5%
Medicare payment on the code vs 2020; billers +1.4% · 2021

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
New Jersey188$6,411,096121,7801152,686
California637$5,975,631155,80383745
New York479$5,785,072144,826841,301
Florida527$5,775,275137,620811,012
Texas575$4,238,762124,05074581
Maryland141$3,881,21469,047721,412
Arkansas100$2,082,71890,5001251,636
Georgia210$2,068,33253,789731,489
Tennessee210$1,554,58745,48961851
Connecticut94$1,477,16030,352801,196
Arizona174$1,291,92635,911100640
Illinois316$1,206,04242,74858324
Massachusetts278$1,160,86238,26669359
Pennsylvania349$1,082,78551,22959462
South Carolina90$710,12121,28671676

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

Not listed: 2 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ473$11,802,714244,954111
Washington-Arlington-Alexandria, DC-VA-MD-WV105$3,858,03473,416119
Los Angeles-Long Beach-Anaheim, CA249$3,520,87176,74498
Dallas-Fort Worth-Arlington, TX163$2,747,51365,96388
Little Rock-North Little Rock-Conway, AR70$1,978,53287,285220
Miami-Fort Lauderdale-West Palm Beach, FL132$1,488,27031,99184
Atlanta-Sandy Springs-Roswell, GA125$1,485,91234,37764
Cape Coral-Fort Myers, FL45$1,096,33324,558139
Boston-Cambridge-Newton, MA-NH231$1,088,09433,14566
Phoenix-Mesa-Chandler, AZ132$1,039,51127,934101
North Port-Bradenton-Sarasota, FL20$1,023,32219,05674
Chicago-Naperville-Elgin, IL-IN263$1,021,71936,88261
Memphis, TN-MS-AR44$830,15217,358153
Orlando-Kissimmee-Sanford, FL62$822,55319,046145
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD187$730,94834,42959

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 2021.

Specialties billing 88313 nationally

Pathology accounts for 57% of payment for 88313 nationally in 2021, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Pathology5,99285%$29,370,61757%1,028,797172
Clinical Laboratory3434.9%$18,003,47535%353,8301,032
Gastroenterology3535.0%$2,797,9825.4%63,100179
Podiatry220.31%$434,7640.85%6,668303
Dermatology1742.5%$358,9790.70%10,37460
Urology380.54%$230,6070.45%6,528172
Internal Medicine170.24%$115,7690.23%3,186187
Ophthalmology180.26%$32,0500.06%1,845103
Hematology-Oncology160.23%$23,9020.05%89556

Not listed: 15 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 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