Medicare spending analysis for Clinical Laboratory providers
Clinical Laboratory accounts for $57.2B in Medicare payments across 29.8K providers.
The specialty's average markup of 3.7x is below the overall Medicare average of 3.77x.
This specialty has been identified by HHS OIG as having elevated fraud risk based on historical enforcement patterns.
AI-generated analysis based on Medicare payment data.
| Year | Payments | Services | Providers | YoY Change |
|---|---|---|---|---|
| 2014 | $5.0B | 367.0M | 2.8K | — |
| 2015 | $5.0B | 352.1M | 2.9K | -1.0% |
| 2016 | $4.6B | 314.8M | 2.9K | -6.8% |
| 2017 | $4.9B | 314.6M | 2.8K | +5.9% |
| 2018 | $5.4B | 313.7M | 2.8K | +9.8% |
| 2019 | $5.6B | 311.2M | 2.8K | +5.0% |
| 2020 | $5.9B | 293.3M | 3.0K | +4.8% |
| 2021 | $6.9B | 299.1M | 3.3K | +16.7% |
| 2022 | $6.4B | 314.8M | 3.4K | -6.7% |
| 2023 | $7.4B | 380.5M | 3.1K | +14.3% |
| Code | Description | Payments | Services | Avg/Service |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | $1.0B | 87.1M | $11.75 |
| 81479 | Molecular pathology procedure | $488.4M | 209.9K | $2.3K |
| 81528 | Gene analysis (colorectal cancer) | $300.9M | 603.6K | $498.52 |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | $243.7M | 7.1M | $34.37 |
| 80053 | Blood test, comprehensive group of blood chemicals | $208.1M | 20.1M | $10.34 |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | $178.7M | 10.9M | $16.45 |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | $176.0M | 13.4M | $13.11 |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | $174.9M | 4.0M | $43.26 |
| 36415 | Insertion of needle into vein for collection of blood sample | $174.5M | 21.1M | $8.27 |
| 82306 | Vitamin d-3 level | $144.3M | 5.0M | $28.98 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $132.0M | 17.4M | $7.60 |
| 81455 | Targeted genomic sequence analysis panel of dna or combine dna and rna of 51 or greater genes associated with blood and lymphatic system disorders | $109.5M | 38.3K | $2.9K |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | $107.8M | 447.6K | $240.89 |
| 0242U | Gene analysis of 55-74 genes associated with solid organ cancer in cell-free circulating dna, targeted genomic sequence analysis panel | $104.7M | 21.4K | $4.9K |
| 81519 | Test for detecting genes associated with breast cancer | $94.7M | 25.0K | $3.8K |
| U0003 | 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, making use of high throughput technologies as described by cms-2020-01-r | $92.6M | 1.3M | $73.48 |
| 83036 | Hemoglobin a1c level | $90.3M | 9.5M | $9.51 |
| 87637 | Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus | $73.0M | 522.6K | $139.74 |
| 81542 | Mrna gene expression analysis of 22 genes in prostate tumor tissue | $71.7M | 18.9K | $3.8K |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | $66.5M | 343.3K | $193.77 |
Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.