HCPCS 20611

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

Procedures Work RVU per service 1.10 (2023 fee schedule)

8,465
97th percentile among 6,405 codes billed · 2023
$76M
97th percentile among 6,405 codes billed · 2023
961K
95th percentile among 6,405 codes billed · 2023
56
76th percentile among 6,405 codes billed · 2023
395
77th percentile among 6,405 codes billed · 2023
+4.7%
Medicare payment on the code vs 2022; billers +2.9% · 2023

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 York744$11,852,635126,21682644
California879$11,573,147134,72765536
Florida622$5,572,71173,28756411
Illinois387$4,704,41557,79376486
Texas565$4,092,20553,71749316
New Jersey341$3,408,62536,62866302
Pennsylvania312$2,465,53031,13653337
Arizona274$2,386,04831,43464402
Virginia226$2,367,57531,88763581
Michigan312$2,258,22131,42465283
Ohio284$1,925,72626,71456302
Maryland197$1,765,64320,69253422
Massachusetts180$1,722,33222,04149432
South Carolina160$1,623,40422,40562608
Tennessee207$1,308,39219,55252333

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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ877$13,455,887139,67982
Los Angeles-Long Beach-Anaheim, CA351$5,667,57564,04294
Chicago-Naperville-Elgin, IL-IN324$4,164,47650,82077
Miami-Fort Lauderdale-West Palm Beach, FL174$1,722,98722,03359
Phoenix-Mesa-Chandler, AZ205$1,529,97320,63462
Boston-Cambridge-Newton, MA-NH152$1,462,08617,97449
Detroit-Warren-Dearborn, MI164$1,427,34318,92573
Washington-Arlington-Alexandria, DC-VA-MD-WV160$1,333,21314,62159
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD144$1,330,23815,35162
San Francisco-Oakland-Fremont, CA100$1,310,80014,01852
San Diego-Chula Vista-Carlsbad, CA119$1,153,37514,59855
Virginia Beach-Chesapeake-Norfolk, VA-NC69$1,090,99614,92691
San Antonio-New Braunfels, TX93$854,12610,95875
Dallas-Fort Worth-Arlington, TX126$830,24510,58334
Houston-Pasadena-The Woodlands, TX111$809,03610,24146

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 91 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 20611 nationally

Orthopedic Surgery accounts for 35% of payment for 20611 nationally in 2023, across 19 specialties on claims.

observed calculated calculated calculated calculated calculated
Orthopedic Surgery1,97523%$26,597,41235%315,073160
Sports Medicine89211%$10,169,00313%133,959150
Physical Medicine and Rehabilitation1,21514%$9,014,19312%110,04691
Physician Assistant1,22314%$7,392,3359.7%107,24888
Family Practice7308.6%$6,658,5568.7%86,236118
Rheumatology4164.9%$4,508,5425.9%53,617129
Nurse Practitioner4024.7%$2,782,1033.6%41,801104
Pain Management4235.0%$2,041,8972.7%25,00659
Internal Medicine1702.0%$1,888,2132.5%21,713128
Anesthesiology2913.4%$1,268,4851.7%15,45253
Interventional Pain Management2543.0%$1,163,2841.5%13,85755
Emergency Medicine750.89%$714,2630.94%9,538127
Diagnostic Radiology2122.5%$477,2000.63%7,79937
Osteopathic Manipulative Medicine270.32%$379,8820.50%4,657172
Hand Surgery500.59%$338,2990.44%4,02080

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 2023.

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