HCPCS 20611

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

Procedures Work RVU per service 1.10 (2022 fee schedule)

8,228
96th percentile among 6,326 codes billed · 2022
$73M
97th percentile among 6,326 codes billed · 2022
915K
95th percentile among 6,326 codes billed · 2022
54
77th percentile among 6,326 codes billed · 2022
388
78th percentile among 6,326 codes billed · 2022
+1.5%
Medicare payment on the code vs 2021; billers +4.9% · 2022

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
California862$11,298,041131,98270572
New York720$11,281,235118,71877658
Florida597$4,732,73362,57447375
Illinois384$4,542,31755,18266470
Texas583$4,219,58955,21951301
New Jersey308$3,344,36835,64471359
Arizona276$2,289,25730,43858373
Pennsylvania301$2,280,06929,04351320
Michigan308$2,249,61931,19559300
Virginia217$2,176,21529,02461577
Ohio274$1,874,67325,83852302
Maryland184$1,667,55919,63350384
Massachusetts171$1,544,32419,44748391
South Carolina148$1,347,29418,86165539
North Carolina189$1,295,13617,25157287

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

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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ827$12,771,760130,97679
Los Angeles-Long Beach-Anaheim, CA345$5,721,35265,53894
Chicago-Naperville-Elgin, IL-IN320$4,045,10548,72668
Phoenix-Mesa-Chandler, AZ210$1,498,28220,20158
Miami-Fort Lauderdale-West Palm Beach, FL160$1,494,39219,04848
Detroit-Warren-Dearborn, MI165$1,412,62318,58966
Boston-Cambridge-Newton, MA-NH143$1,325,01116,04248
San Francisco-Oakland-Fremont, CA93$1,287,16714,01158
Washington-Arlington-Alexandria, DC-VA-MD-WV156$1,271,41514,09155
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD147$1,263,25914,62061
San Diego-Chula Vista-Carlsbad, CA123$1,168,34314,60866
San Antonio-New Braunfels, TX106$1,009,41912,95675
Virginia Beach-Chesapeake-Norfolk, VA-NC64$900,25012,345100
Houston-Pasadena-The Woodlands, TX117$808,46910,25841
Dallas-Fort Worth-Arlington, TX124$786,67310,10534

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 2022.

Specialties billing 20611 nationally

Orthopedic Surgery accounts for 36% of payment for 20611 nationally in 2022, across 19 specialties on claims.

observed calculated calculated calculated calculated calculated
Orthopedic Surgery2,01324%$26,029,85836%307,950153
Physical Medicine and Rehabilitation1,16114%$8,842,32412%107,49393
Sports Medicine8109.8%$8,759,41512%115,057142
Physician Assistant1,10013%$6,365,4848.7%92,79484
Family Practice6748.2%$5,830,1588.0%75,628112
Rheumatology4395.3%$4,769,2096.5%57,151130
Nurse Practitioner4115.0%$3,108,9394.3%46,129112
Pain Management4155.0%$2,081,2672.9%25,60362
Internal Medicine1632.0%$1,987,7352.7%22,416138
Interventional Pain Management2733.3%$1,279,5611.8%15,23356
Anesthesiology2863.5%$1,267,2801.7%15,69255
Emergency Medicine630.77%$661,7420.91%8,578136
Diagnostic Radiology2252.7%$508,5860.70%8,25237
Hand Surgery530.64%$357,5690.49%4,14378
Osteopathic Manipulative Medicine290.35%$342,0210.47%4,125142

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 2022.

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