HCPCS 20611

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

Procedures Work RVU per service 1.10 (2021 fee schedule)

7,844
96th percentile among 6,253 codes billed · 2021
$72M
97th percentile among 6,253 codes billed · 2021
893K
95th percentile among 6,253 codes billed · 2021
56
77th percentile among 6,253 codes billed · 2021
406
79th percentile among 6,253 codes billed · 2021
+21.7%
Medicare payment on the code vs 2020; billers +9.3% · 2021

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
New York676$10,800,388113,81586609
California813$10,792,908124,71167548
Illinois369$4,851,35258,15471483
Florida539$4,600,94359,41752374
Texas560$4,330,55955,55151361
New Jersey288$3,366,24335,26769391
Virginia220$2,347,00831,09360541
Arizona254$2,257,70330,08360380
Michigan288$2,159,84629,04260324
Pennsylvania274$1,911,73824,36250269
Ohio261$1,708,65423,26453278
Maryland186$1,676,00819,63954361
Tennessee202$1,411,37420,68452352
Massachusetts160$1,380,08116,96851358
North Carolina184$1,343,25517,93766282

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

Not listed: 3 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ765$12,306,318125,92591
Los Angeles-Long Beach-Anaheim, CA322$5,476,49862,11993
Chicago-Naperville-Elgin, IL-IN298$4,163,94649,17271
Phoenix-Mesa-Chandler, AZ192$1,476,68719,94361
Miami-Fort Lauderdale-West Palm Beach, FL152$1,426,61317,75361
Detroit-Warren-Dearborn, MI158$1,385,92717,67562
Washington-Arlington-Alexandria, DC-VA-MD-WV156$1,320,47714,56155
San Francisco-Oakland-Fremont, CA95$1,253,90313,51658
Boston-Cambridge-Newton, MA-NH138$1,194,82814,30149
San Antonio-New Braunfels, TX104$1,082,07913,66778
Virginia Beach-Chesapeake-Norfolk, VA-NC59$1,048,79014,150112
San Diego-Chula Vista-Carlsbad, CA105$1,037,10912,84866
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD140$1,023,79811,67754
Houston-Pasadena-The Woodlands, TX116$801,93310,23346
Baltimore-Columbia-Towson, MD93$757,7309,45054

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 87 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.

Specialties billing 20611 nationally

Orthopedic Surgery accounts for 37% of payment for 20611 nationally in 2021, across 19 specialties on claims.

observed calculated calculated calculated calculated calculated
Orthopedic Surgery2,00426%$26,466,01937%311,308155
Physical Medicine and Rehabilitation1,11514%$8,798,76912%105,05994
Sports Medicine7269.3%$7,469,12610%96,876133
Physician Assistant93912%$5,519,5567.7%79,55485
Family Practice6217.9%$5,345,5327.4%68,400110
Rheumatology4415.6%$5,015,6617.0%59,839136
Nurse Practitioner4215.4%$3,714,1265.2%56,179133
Internal Medicine1792.3%$2,376,8123.3%26,861150
Pain Management3724.7%$2,108,1602.9%25,77169
Interventional Pain Management2733.5%$1,370,6801.9%16,22459
Anesthesiology2813.6%$1,289,6551.8%15,88757
Diagnostic Radiology2252.9%$575,1470.80%8,80039
Emergency Medicine520.66%$556,6640.77%7,226139
Hand Surgery520.66%$299,9800.42%3,45266
Osteopathic Manipulative Medicine270.34%$285,9190.40%3,479129

Not listed: 14 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 2021.

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