CMS Releases 2023 Part B Utilization by CPT Code, Lab or Physician

Each year, CMS releases a cloud database of provider and CPT code utilization for the calendar year about 18 months earlier - e.g. CY2023 data released around May-June 2025.   CMS released data for CY2023 on April 24, 2025.

Find the entry point here:

https://data.cms.gov/provider-summary-by-type-of-service/medicare-physician-other-practitioners

For example, you can enter this database:

https://data.cms.gov/provider-summary-by-type-of-service/medicare-physician-other-practitioners/medicare-physician-other-practitioners-by-provider-and-service/data

Physician and Other Practitioners [& Labs] - By Provider and Service.   If you enter the NPI for, for example, Neogenomics (100325317) you get all the 2023 Part B payments to that lab by CPT code.

The database requires a little time to understand, but basically you use options under the button FILTER and when satisfied, you click EXPORT and get a CVS (comma) file which I recommend you immediately open and re-save as an XLS file.   

The full cloud database you are searching has about 9.6 million rows of data.  (Whereas, for example, if you filter on the NPI for Neogenomics, you get 274 rows).   

I Was Not Sure This Would Happen

For about a decade, CMS has been releasing this doctor-specific (or lab-specific) payment data, based on a legacy of federal court cases on whether they were private or releasable.   Frankly…I couldn't have guaranteed they would be released under the current new administration - but here they are.

81479 in 2023

If you search on the molecular unlisted code 81479, you get 80 rows.  The payments for 81479 tally to $488,385,801 in total.  That is, despite the explosion of 500-plus PLA codes, nearly half a billion dollars goes out via 81479.   

The top 8 payments for 81479, totalling about 90% of payments, are all in MolDx states.  Click to enlarge:

Click to enlarge

Searching on Ambry Genetics, you get 174 services for 0101U, 466 services for 0129U, and a whopping 22,503 services for 81479.   

Dollarized, that’s $297,378, and $593,548, and $39,922,313 (0.7%, 1.5%, 97.8%).

The wide use of 81479 in MolDx's coding instructions to labs means that huge amounts of genomics payments fall under 81479 and public health data researchers can't tell what is actually being tested and used by doctors and patients.  (MolDx knows, because each of those 81479 uses is paired with a Z code).

In addition, all those 81479 payments fall outside of PAMA data collection or application.   

Broader Filters

You can do broader filters, such as "starts with 81" to get molecular codes and then manually truncate (erase) the results up to code 81599.   You can search with "ends with U" to get PLA codes - et cetera.

81408 "Fraudomatic Code"

Wild use of code 81408 led to around a billion dollars of payments around 2018-2021.   Utilization in 2023 was essentially zero (11 uses).