HCPCS 11042

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

Procedures Work RVU per service 1.01 (2022 fee schedule)

10,444
97th percentile among 6,326 codes billed · 2022
$123M
98th percentile among 6,326 codes billed · 2022
1.8M
97th percentile among 6,326 codes billed · 2022
85
84th percentile among 6,326 codes billed · 2022
602
83rd percentile among 6,326 codes billed · 2022
-2.0%
Medicare payment on the code vs 2021; billers -0.1% · 2022

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
California931$19,098,008222,174103802
Florida986$18,875,778266,348112991
Texas735$10,033,797147,55783790
New York517$6,322,87379,84374498
Illinois475$5,334,73273,99990522
New Jersey427$5,081,52166,01184485
Ohio528$3,879,04267,13084388
Pennsylvania432$3,335,30348,80968314
North Carolina312$3,174,26355,30994612
Indiana287$2,976,83850,213104534
Massachusetts255$2,845,04944,34895534
Michigan379$2,649,71839,75668272
Maryland223$2,494,14632,87980445
Virginia243$2,319,08034,73180486
Tennessee254$2,298,92638,69094468

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 2022.

Top metro areas

observed calculated calculated calculated calculated
Miami-Fort Lauderdale-West Palm Beach, FL348$10,777,072145,257169
Los Angeles-Long Beach-Anaheim, CA342$10,261,769108,170109
New York-Newark-Jersey City, NY-NJ643$8,468,005100,53678
Chicago-Naperville-Elgin, IL-IN369$4,436,83258,87090
Dallas-Fort Worth-Arlington, TX227$4,330,61261,927101
Washington-Arlington-Alexandria, DC-VA-MD-WV164$2,454,57033,573116
Boston-Cambridge-Newton, MA-NH176$1,858,45028,51785
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD209$1,829,37224,26666
Houston-Pasadena-The Woodlands, TX155$1,805,67423,46585
Riverside-San Bernardino-Ontario, CA87$1,729,12422,60379
Orlando-Kissimmee-Sanford, FL83$1,472,06122,46099
Detroit-Warren-Dearborn, MI190$1,341,05118,14669
Phoenix-Mesa-Chandler, AZ144$1,187,90315,95872
Tampa-St. Petersburg-Clearwater, FL107$1,138,31119,09986
San Francisco-Oakland-Fremont, CA86$1,062,95912,88387

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 97 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2022.

Specialties billing 11042 nationally

Podiatry accounts for 41% of payment for 11042 nationally in 2022, across 24 specialties on claims.

observed calculated calculated calculated calculated calculated
Podiatry5,21650%$50,202,28441%596,766114
Family Practice6556.3%$17,711,46414%267,660409
Nurse Practitioner1,61015%$16,041,62413%297,421185
General Surgery9328.9%$12,040,1809.8%200,459215
Physician Assistant3753.6%$4,838,9993.9%74,308198
Internal Medicine3263.1%$4,763,6503.9%80,395247
Emergency Medicine2452.3%$2,725,2792.2%55,165225
Vascular Surgery2472.4%$1,831,2591.5%30,085122
Plastic and Reconstructive Surgery1771.7%$1,518,6941.2%25,107142
General Practice680.65%$1,433,6201.2%19,949293
Undersea and Hyperbaric Medicine660.63%$1,151,7730.94%20,421309
Infectious Disease1201.1%$1,047,9980.86%18,842157
Physical Medicine and Rehabilitation510.49%$764,7720.62%14,377282
Orthopedic Surgery670.64%$652,2560.53%10,430156
Obstetrics & Gynecology240.23%$285,5780.23%4,914205

Not listed: 25 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 2022.

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