HCPCS 88313

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

Laboratory Work RVU per service 0.24 (2023 fee schedule)

6,757
96th percentile among 6,405 codes billed · 2023
$50M
96th percentile among 6,405 codes billed · 2023
1.4M
96th percentile among 6,405 codes billed · 2023
66
79th percentile among 6,405 codes billed · 2023
693
83rd percentile among 6,405 codes billed · 2023
+2.5%
Medicare payment on the code vs 2022; billers -0.2% · 2023

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
California669$6,625,813163,62877788
New York469$5,680,716139,915801,208
New Jersey182$5,673,285107,1231053,402
Florida472$5,471,332129,648791,096
Maryland138$4,054,31869,880731,857
Texas551$3,712,922105,66175584
Georgia210$2,142,20054,611711,141
Arkansas105$1,885,33987,4291531,092
Pennsylvania309$1,715,92259,30566739
Arizona169$1,711,57943,11597960
Tennessee203$1,532,47247,226651,025
Connecticut104$1,146,84924,22864690
Illinois282$1,068,17736,29056318
South Carolina127$847,25724,50474408
Massachusetts274$772,54132,68463358

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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ480$10,495,923222,039105
Washington-Arlington-Alexandria, DC-VA-MD-WV98$4,025,14877,33395
Los Angeles-Long Beach-Anaheim, CA274$3,994,44583,60486
Dallas-Fort Worth-Arlington, TX145$2,203,72452,44892
Little Rock-North Little Rock-Conway, AR79$1,808,78784,736198
Atlanta-Sandy Springs-Roswell, GA131$1,680,21939,18163
Miami-Fort Lauderdale-West Palm Beach, FL116$1,388,84528,50883
Phoenix-Mesa-Chandler, AZ126$1,315,91831,418104
Cape Coral-Fort Myers, FL24$1,132,38923,784145
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD169$1,010,86735,97971
Orlando-Kissimmee-Sanford, FL55$915,00619,534133
Memphis, TN-MS-AR42$902,14919,018124
Chicago-Naperville-Elgin, IL-IN238$887,87931,48964
Houston-Pasadena-The Woodlands, TX186$750,91324,68067
Boston-Cambridge-Newton, MA-NH222$710,94227,80465

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 2023.

Specialties billing 88313 nationally

Pathology accounts for 59% of payment for 88313 nationally in 2023, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Pathology5,76585%$29,600,90059%988,034171
Clinical Laboratory3355.0%$15,744,85831%319,117953
Gastroenterology3545.2%$2,843,1835.7%65,170184
Dermatology1672.5%$1,151,9122.3%19,623118
Podiatry160.24%$371,7870.74%5,862366
Urology320.47%$191,8790.38%6,138192
Internal Medicine310.46%$160,9390.32%4,594148
Ophthalmology180.27%$26,8020.05%1,845103
Hematology-Oncology130.19%$15,1340.03%54242

Not listed: 13 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 2023.

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