- See the OIG 4th Annual Report here.
- Appendix A provides links to prior OIG reports.
- See coverage at 360DX here.
In this blog, I summarized data from Part B CY2017, and also provided links to the CMS spreadsheets. My article focuses on the top 10 molecular codes. That article is here.
By code, the highest paid codes were 84443 (TSH), $484M, blood panel 80053, $473M, CBC 85025, $432M, lipds 80061, $415M, and Vitamin D 82306, $348M. Next up were 22 or more drug tests, G0483, $307M, and A1c 83036, $257M. The highest molecular test, Cologuard, 81528, came in #12 overall at $117M.
Comparing data from the 2017 CMS spreadsheets for regular Part B independent labs and the OIG summary data (which includes hospital reference labs) allows the hospital lab billing to be imputed at least for the top 25 codes for which OIG provides data.
The OIG report provides summary data only on the top 25 CPT codes. Obviously, they could easily provide a cloud link to a table or spreadsheet with all the codes.
Per the report's Exhibit 2, 1% of labs got 55% of payments; 5% of labs got 79% of payments. The remaining 95% of labs got 21% of payments.