HCPCS 20611

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

Procedures Work RVU per service 1.10 (2020 fee schedule)

7,177
96th percentile among 6,116 codes billed · 2020
$59M
97th percentile among 6,116 codes billed · 2020
782K
95th percentile among 6,116 codes billed · 2020
54
78th percentile among 6,116 codes billed · 2020
378
79th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$50M2020: $59M paid20202021: $72M paid20212022: $73M paid20222023: $76M paid20232024: $78M paid2024$78M$0$50M2020: $59M paid20202021: $72M paid20212022: $73M paid20222023: $76M paid20232024: $78M paid2024$78M$0$50M2020: $59M paid20202021: $72M paid20212022: $73M paid20222023: $76M paid20232024: $78M paid2024$78M$0$50M2020: $59M paid20202021: $72M paid20212022: $73M paid20222023: $76M paid20232024: $78M paid2024$78M

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

Billers

05,0002020: 7,177 providers20202021: 7,844 providers20212022: 8,228 providers20222023: 8,465 providers20232024: 8,929 providers20248,92905,0002020: 7,177 providers20202021: 7,844 providers20212022: 8,228 providers20222023: 8,465 providers20232024: 8,929 providers20248,92905,0002020: 7,177 providers20202021: 7,844 providers20212022: 8,228 providers20222023: 8,465 providers20232024: 8,929 providers20248,92905,0002020: 7,177 providers20202021: 7,844 providers20212022: 8,228 providers20222023: 8,465 providers20232024: 8,929 providers20248,929

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
20248,929$78,037,375+2%1,011,305563991.10
20238,465$76,334,200+5%961,359563951.10
20228,228$72,935,887+2%915,425543881.10
20217,844$71,843,251+22%892,949564061.10
20207,177$59,041,921first year in data782,196543781.10

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
California749$8,949,453109,24265523
New York633$8,723,26499,82778579
Illinois349$4,267,06354,93871481
Florida483$3,967,97254,14649361
Texas505$3,753,30351,60954332
New Jersey269$2,581,71729,11465330
Virginia202$1,958,83127,61252504
Arizona246$1,926,47027,16958380
Michigan276$1,819,94825,78855265
Ohio244$1,432,93420,90850241
Pennsylvania236$1,404,38518,84850257
Maryland172$1,395,75017,65358362
Tennessee184$1,233,09818,87658352
North Carolina164$1,115,13816,03964300
Massachusetts141$1,057,25213,64651285

Not listed: 4 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
New York-Newark-Jersey City, NY-NJ709$9,713,100107,66880
Los Angeles-Long Beach-Anaheim, CA290$4,549,42054,48880
Chicago-Naperville-Elgin, IL-IN287$3,574,96445,38567
Phoenix-Mesa-Chandler, AZ185$1,290,35018,02457
Miami-Fort Lauderdale-West Palm Beach, FL140$1,220,40016,13557
Detroit-Warren-Dearborn, MI142$1,118,82915,25652
San Francisco-Oakland-Fremont, CA87$1,008,95611,34864
Washington-Arlington-Alexandria, DC-VA-MD-WV144$986,79011,69951
Boston-Cambridge-Newton, MA-NH122$927,59511,75547
San Antonio-New Braunfels, TX89$906,41212,44193
San Diego-Chula Vista-Carlsbad, CA101$874,51411,39651
Virginia Beach-Chesapeake-Norfolk, VA-NC58$835,07411,89786
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD126$778,7589,66451
Baltimore-Columbia-Towson, MD91$753,1309,99558
Houston-Pasadena-The Woodlands, TX102$653,1518,85449

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 85 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 20611 nationally

Orthopedic Surgery accounts for 38% of payment for 20611 nationally in 2020, across 17 specialties on claims.

observed calculated calculated calculated calculated calculated
Orthopedic Surgery1,90627%$22,387,84638%283,007148
Physical Medicine and Rehabilitation1,05115%$7,144,71812%90,98287
Sports Medicine6228.7%$5,488,4329.3%75,719122
Rheumatology4476.2%$4,721,2878.0%60,400135
Physician Assistant80611%$4,319,9827.3%66,90083
Family Practice5587.8%$4,163,7767.1%56,687102
Nurse Practitioner3805.3%$2,688,8094.6%43,198114
Internal Medicine1702.4%$2,161,5163.7%25,847152
Pain Management3324.6%$1,645,0722.8%21,56865
Interventional Pain Management2713.8%$1,250,1242.1%16,01559
Anesthesiology2453.4%$1,122,8621.9%14,60360
Emergency Medicine390.54%$431,9780.73%6,026155
Diagnostic Radiology1732.4%$421,5960.71%6,86340
Hand Surgery450.63%$233,5400.40%2,82763
Osteopathic Manipulative Medicine200.28%$208,9330.35%2,700135

Not listed: 19 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 20611 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