HCPCS 11042

Procedure (ClaimLight category; the code descriptor is not shown)

Procedures Work RVU per service 1.01 (2020 fee schedule)

10,153
97th percentile among 6,116 codes billed · 2020
$115M
98th percentile among 6,116 codes billed · 2020
1.7M
97th percentile among 6,116 codes billed · 2020
89
86th percentile among 6,116 codes billed · 2020
575
83rd percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$50M$100M2020: $115M paid20202021: $125M paid20212022: $123M paid20222023: $120M paid20232024: $123M paid2024$123M$0$50M$100M2020: $115M paid20202021: $125M paid20212022: $123M paid20222023: $120M paid20232024: $123M paid2024$123M$0$50M$100M2020: $115M paid20202021: $125M paid20212022: $123M paid20222023: $120M paid20232024: $123M paid2024$123M$0$50M$100M2020: $115M paid20202021: $125M paid20212022: $123M paid20222023: $120M paid20232024: $123M paid2024$123M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

05,00010K2020: 10K providers20202021: 10K providers20212022: 10K providers20222023: 11K providers20232024: 11K providers202411K05,00010K2020: 10K providers20202021: 10K providers20212022: 10K providers20222023: 11K providers20232024: 11K providers202411K05,00010K2020: 10K providers20202021: 10K providers20212022: 10K providers20222023: 11K providers20232024: 11K providers202411K05,00010K2020: 10K providers20202021: 10K providers20212022: 10K providers20222023: 11K providers20232024: 11K providers202411K

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
202411,297$122,559,884+2%1,868,578895551.01
202310,712$120,437,929-2%1,805,801865821.01
202210,444$122,529,005-2%1,789,591856021.01
202110,451$125,062,697+9%1,824,531886061.01
202010,153$115,171,083first year in data1,721,139895751.01

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
Florida983$19,664,530279,6121241,153
California889$15,702,071196,353104784
Texas657$7,840,789121,80197625
Illinois476$5,367,25572,90582521
New York468$5,145,75366,83478508
New Jersey402$4,533,89261,39985546
Ohio525$3,997,99467,51884373
North Carolina338$3,631,50262,325105693
Pennsylvania443$3,333,93549,53666331
Michigan372$2,949,49442,90183317
Indiana265$2,807,83248,423104554
Massachusetts227$2,537,00040,25192555
Tennessee242$2,370,74039,272101504
Maryland201$2,353,58330,97987477
Virginia237$2,308,83835,08382516

Not listed: 1 billers with an armed-forces or unknown state code (XX); they are in the national totals.

Not listed: 6 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 2020.

Top metro areas

observed calculated calculated calculated calculated
Miami-Fort Lauderdale-West Palm Beach, FL357$11,765,051164,760204
Los Angeles-Long Beach-Anaheim, CA320$6,968,82082,929116
New York-Newark-Jersey City, NY-NJ591$6,932,59884,97078
Chicago-Naperville-Elgin, IL-IN357$4,239,57954,84182
Washington-Arlington-Alexandria, DC-VA-MD-WV170$2,253,49431,16396
Dallas-Fort Worth-Arlington, TX179$2,072,36032,167103
Riverside-San Bernardino-Ontario, CA75$1,792,75922,917136
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD210$1,774,18823,66270
Detroit-Warren-Dearborn, MI185$1,639,90721,93389
Boston-Cambridge-Newton, MA-NH153$1,482,08622,03981
Houston-Pasadena-The Woodlands, TX136$1,421,60419,80087
Orlando-Kissimmee-Sanford, FL77$1,160,87116,513114
Tampa-St. Petersburg-Clearwater, FL111$1,126,50218,05788
St. Louis, MO-IL93$1,099,69115,345113
Cincinnati, OH-KY-IN90$1,041,48817,790114

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 95 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing 11042 nationally

Podiatry accounts for 46% of payment for 11042 nationally in 2020, across 24 specialties on claims.

observed calculated calculated calculated calculated calculated
Podiatry5,19451%$52,713,47846%647,387125
Family Practice6766.7%$17,262,96415%268,728398
General Surgery1,03610%$11,617,95710%198,661192
Nurse Practitioner1,15011%$10,060,6138.7%198,029172
Internal Medicine3433.4%$4,417,3153.8%79,068231
Physician Assistant3083.0%$3,702,5343.2%60,702197
Emergency Medicine2442.4%$3,014,3952.6%60,477248
Vascular Surgery2812.8%$1,965,6021.7%33,137118
Plastic and Reconstructive Surgery2172.1%$1,824,7951.6%32,393149
Undersea and Hyperbaric Medicine650.64%$1,365,6521.2%22,523347
Infectious Disease1291.3%$1,065,4740.93%20,103156
Physical Medicine and Rehabilitation620.61%$881,7310.77%16,404265
General Practice510.50%$846,8830.74%12,603247
Orthopedic Surgery810.80%$610,5390.53%10,136125
Ambulatory Surgical Center110.11%$488,7420.42%4,058369

Not listed: 30 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 2020.

Top billers of 11042 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