HCPCS 11042

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

Procedures Work RVU per service 1.01 (2023 fee schedule)

10,712
97th percentile among 6,405 codes billed · 2023
$120M
98th percentile among 6,405 codes billed · 2023
1.8M
97th percentile among 6,405 codes billed · 2023
86
84th percentile among 6,405 codes billed · 2023
582
81st percentile among 6,405 codes billed · 2023
-1.7%
Medicare payment on the code vs 2022; billers +2.6% · 2023

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
California1,032$18,653,014225,721103716
Florida1,003$17,409,063257,727103932
Texas791$10,311,169152,41687717
New York502$6,077,65980,60678530
New Jersey437$5,090,04067,80082486
Illinois477$4,816,79970,10285471
Ohio536$4,029,47570,69888380
Pennsylvania434$3,388,54250,74874326
North Carolina328$2,942,31353,09885519
Massachusetts245$2,815,02645,07498535
Indiana292$2,744,48648,64797508
Virginia270$2,587,28338,42183481
Maryland214$2,494,02032,96590468
Michigan356$2,381,60436,94175309
Tennessee250$2,267,58340,12996523

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

Not listed: 5 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 2023.

Top metro areas

observed calculated calculated calculated calculated
Los Angeles-Long Beach-Anaheim, CA403$9,442,725106,124116
Miami-Fort Lauderdale-West Palm Beach, FL358$9,197,542128,386152
New York-Newark-Jersey City, NY-NJ636$8,334,233104,02380
Dallas-Fort Worth-Arlington, TX243$4,219,67659,56799
Chicago-Naperville-Elgin, IL-IN367$3,970,51954,70693
Washington-Arlington-Alexandria, DC-VA-MD-WV164$2,300,45431,959107
Boston-Cambridge-Newton, MA-NH164$1,918,27129,32699
Riverside-San Bernardino-Ontario, CA85$1,795,06324,020107
Houston-Pasadena-The Woodlands, TX166$1,766,14923,34087
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD227$1,701,76923,60064
Orlando-Kissimmee-Sanford, FL89$1,269,41220,110101
Tampa-St. Petersburg-Clearwater, FL113$1,177,23618,63384
Phoenix-Mesa-Chandler, AZ159$1,137,84015,31367
Detroit-Warren-Dearborn, MI169$1,125,98615,62963
San Francisco-Oakland-Fremont, CA100$1,117,95613,68362

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 94 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing 11042 nationally

Podiatry accounts for 38% of payment for 11042 nationally in 2023, across 21 specialties on claims.

observed calculated calculated calculated calculated calculated
Podiatry5,09848%$46,341,37338%568,698112
Nurse Practitioner2,04619%$20,485,51717%367,816180
Family Practice6446.0%$14,781,95112%226,880352
General Surgery8237.7%$12,164,82310%203,201247
Internal Medicine3373.1%$5,869,7524.9%90,912270
Physician Assistant4524.2%$5,813,3954.8%89,458198
Emergency Medicine2472.3%$2,846,9182.4%57,771234
General Practice700.65%$1,996,4981.7%26,579380
Vascular Surgery2462.3%$1,673,1571.4%29,215119
Plastic and Reconstructive Surgery1751.6%$1,474,4171.2%24,846142
Undersea and Hyperbaric Medicine670.63%$1,259,3081.0%20,213302
Infectious Disease1221.1%$1,085,8750.90%19,756162
Orthopedic Surgery700.65%$583,1630.48%9,682138
Physical Medicine and Rehabilitation480.45%$579,6260.48%11,803246
Obstetrics & Gynecology210.20%$336,7030.28%5,773275

Not listed: 31 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 2023.

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