In an excel spreadsheet in the cloud, I've pulled the molecular pathology codes. They are sorted three ways: (1) by volume of services per code, (2) by dollars paid by Medicare per code, and (3) a separate table only for Tier 2 codes. In the cloud, here. (Download by clicking the small down arrow, upper right in most views).
For screen shots, see larger view by clicking on the images below.
- By volume, the Tier 2 code 81401 leads, with 422,556 services, while seven codes had >200,000 services and then the usage dropped suddenly to <60,000. 80% of codes had less than 10,000 uses by CMS, half had less than 1000 uses by CMS. One-third of the codes shown were paid by CMS at least once, but less than 100 times.
- By dollars, in 2014, two Cyp genes led in Medicare payments, with $273M in total payments or about 50% of all CMS molecular payments. 75% of codes listed had 2% of CMS dollar payments.
- Among Tier 2 codes, 81401/Level 2, dwarfs all other Tier 2 codes, with about 80% of Tier 2 utilization and $46M paid or about $110 per CMS claim. Only 2 providers submitted any Level 3 codes, with a total of just 17 tests paid and grand total of $4,700.
Again, for full views, download spreadsheet from the link near the top of this blog.