HCPCS 88313

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

Laboratory Work RVU per service 0.24 (2022 fee schedule)

6,772
96th percentile among 6,326 codes billed · 2022
$49M
96th percentile among 6,326 codes billed · 2022
1.4M
96th percentile among 6,326 codes billed · 2022
65
80th percentile among 6,326 codes billed · 2022
694
84th percentile among 6,326 codes billed · 2022
-4.8%
Medicare payment on the code vs 2021; billers -3.4% · 2022

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 Jersey174$5,754,804109,4081192,518
Florida505$5,691,130131,72379925
New York488$5,586,458142,819791,115
California653$5,550,187150,10577782
Maryland131$3,766,56364,297741,862
Texas557$3,639,727107,84772649
Arkansas109$2,174,96786,6711451,226
Georgia184$2,173,79754,274841,465
Tennessee192$1,582,33746,67574905
Arizona169$1,424,28936,13789827
Pennsylvania312$1,229,83750,69861549
Illinois302$1,221,26040,09157303
Connecticut103$1,180,96725,40462685
Virginia140$844,24134,27974795
Massachusetts261$761,56130,04763288

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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ481$10,929,364232,935122
Washington-Arlington-Alexandria, DC-VA-MD-WV97$3,856,49574,048124
Los Angeles-Long Beach-Anaheim, CA271$3,129,71772,44080
Dallas-Fort Worth-Arlington, TX156$2,093,18753,35779
Little Rock-North Little Rock-Conway, AR83$2,089,61483,781203
Atlanta-Sandy Springs-Roswell, GA108$1,667,65537,13355
Miami-Fort Lauderdale-West Palm Beach, FL123$1,490,54931,02584
Phoenix-Mesa-Chandler, AZ125$1,244,97730,52690
Cape Coral-Fort Myers, FL42$1,077,19923,386101
Chicago-Naperville-Elgin, IL-IN253$1,046,02834,59363
North Port-Bradenton-Sarasota, FL18$1,030,13118,575112
Memphis, TN-MS-AR38$932,35018,903182
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD168$872,67533,59372
Houston-Pasadena-The Woodlands, TX183$835,32825,92469
Orlando-Kissimmee-Sanford, FL59$834,17118,024125

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 79 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 88313 nationally

Pathology accounts for 60% of payment for 88313 nationally in 2022, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Pathology5,80686%$29,207,24660%985,123170
Clinical Laboratory3324.9%$15,955,21533%316,673954
Gastroenterology3314.9%$2,423,7655.0%55,727168
Dermatology1672.5%$446,5720.91%10,09460
Podiatry170.25%$424,3650.87%6,608389
Urology340.50%$224,6230.46%7,060208
Internal Medicine220.32%$154,4550.32%4,185190
Ophthalmology200.30%$26,8870.05%1,76088

Not listed: 16 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 2022.

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