HCPCS U0005

Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within (CMS descriptor)

Other services Work RVU per service none (2022 fee schedule; adds 0 work RVUs)

3,802
94th percentile among 6,326 codes billed · 2022
$194M
99th percentile among 6,326 codes billed · 2022
7.8M
99th percentile among 6,326 codes billed · 2022
36
66th percentile among 6,326 codes billed · 2022
9,667
98th percentile among 6,326 codes billed · 2022
-15.2%
Medicare payment on the code vs 2021; billers +9.6% · 2022

Trend

Medicare payment on the code

$0$100M$200M2021: $229M paid20212022: $194M paid20222023: $36M paid2023$36M$0$100M$200M2021: $229M paid20212022: $194M paid20222023: $36M paid2023$36M$0$100M$200M2021: $229M paid20212022: $194M paid20222023: $36M paid2023$36M$0$100M$200M2021: $229M paid20212022: $194M paid20222023: $36M paid2023$36M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2021–2023.

Billers

02,0004,0002021: 3,469 providers20212022: 3,802 providers20222023: 1,090 providers20231,09002,0004,0002021: 3,469 providers20212022: 3,802 providers20222023: 1,090 providers20231,09002,0004,0002021: 3,469 providers20212022: 3,802 providers20222023: 1,090 providers20231,09002,0004,0002021: 3,469 providers20212022: 3,802 providers20222023: 1,090 providers20231,090

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2021–2023.

observed calculated calculated calculated calculated calculated reported
20231,090$36,198,574-81%1,477,810995,558
20223,802$193,861,115-15%7,841,589369,6670.00
20213,469$228,648,517not in the 2020 file9,161,2074011,1010.00

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2021–2023.

By state

observed calculated calculated calculated calculated calculated
California205$40,684,6191,645,9801,59739,434
Illinois341$20,299,125822,560337,357
New Jersey230$19,347,655782,9004815,272
Texas187$15,997,212645,78920312,776
New York430$10,882,935440,561331,586
Florida191$7,960,064321,9984910,854
North Carolina84$7,215,831291,674273,362
Tennessee134$5,923,649239,077253,116
Pennsylvania36$5,786,962234,23898226,314
Louisiana26$4,936,608199,53922953,594
Maryland78$4,607,088186,07111212,888
Virginia53$4,490,910181,4154212,095
Arizona21$3,493,302140,97052430,006
Georgia89$3,357,644135,4421666,844
Washington315$3,346,425135,32731325

Not listed: 18 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-NJ436$27,615,7451,117,60243
Los Angeles-Long Beach-Anaheim, CA123$25,774,8611,042,4821,861
Chicago-Naperville-Elgin, IL-IN339$20,321,810823,44233
Austin-Round Rock-San Marcos, TX55$6,353,253256,70020
San Diego-Chula Vista-Carlsbad, CA22$5,249,502212,365997
Nashville-Davidson--Murfreesboro--Franklin, TN13$5,070,062204,583352
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD19$5,025,833203,5873,128
Houston-Pasadena-The Woodlands, TX49$4,550,342183,544701
Dallas-Fort Worth-Arlington, TX58$4,272,129172,415256
Washington-Arlington-Alexandria, DC-VA-MD-WV73$4,131,531166,81487
Phoenix-Mesa-Chandler, AZ18$3,454,168139,386615
Raleigh-Cary, NC15$3,264,691131,98122
Atlanta-Sandy Springs-Roswell, GA73$2,777,243112,034153
Richmond, VA17$2,393,25496,52636
Miami-Fort Lauderdale-West Palm Beach, FL46$2,348,00994,723196

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 34 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 U0005 nationally

Clinical Laboratory accounts for 96% of payment for U0005 nationally in 2022, across 19 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory1,06028%$186,319,26996%7,534,8027,108
Pathology651.7%$2,538,6051.3%102,6081,579
Family Practice66517%$1,035,3270.53%42,08863
Emergency Medicine1313.4%$945,6480.49%38,262292
Nurse Practitioner45112%$669,2440.35%27,19160
Internal Medicine57415%$637,2470.33%26,59346
Physician Assistant39010%$488,0290.25%19,82151
Obstetrics & Gynecology110.29%$212,7720.11%8,613783
Gastroenterology952.5%$210,7220.11%9,00095
Hematology-Oncology120.32%$163,1450.08%6,603550
Pulmonary Disease310.82%$48,7360.03%1,97564
General Surgery411.1%$46,3690.02%1,88546
Orthopedic Surgery391.0%$42,9480.02%1,74445
Urology381.00%$39,9480.02%1,61943
Ophthalmology150.39%$26,3590.01%1,07372

Not listed: 33 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 U0005 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