HCPCS 27130

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

Procedures Work RVU per service 19.60 (2021 fee schedule)

7,343
96th percentile among 6,253 codes billed · 2021
$214M
99th percentile among 6,253 codes billed · 2021
239K
90th percentile among 6,253 codes billed · 2021
24
50th percentile among 6,253 codes billed · 2021
82
51st percentile among 6,253 codes billed · 2021
+40.5%
Medicare payment on the code vs 2020; billers +11.0% · 2021

Trend

Medicare payment on the code

$0$200M2020: $153M paid20202021: $214M paid20212022: $258M paid20222023: $299M paid20232024: $333M paid2024$333M$0$200M2020: $153M paid20202021: $214M paid20212022: $258M paid20222023: $299M paid20232024: $333M paid2024$333M$0$200M2020: $153M paid20202021: $214M paid20212022: $258M paid20222023: $299M paid20232024: $333M paid2024$333M$0$200M2020: $153M paid20202021: $214M paid20212022: $258M paid20222023: $299M paid20232024: $333M paid2024$333M

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

Billers

05,0002020: 6,616 providers20202021: 7,343 providers20212022: 7,781 providers20222023: 8,062 providers20232024: 8,193 providers20248,19305,0002020: 6,616 providers20202021: 7,343 providers20212022: 7,781 providers20222023: 8,062 providers20232024: 8,193 providers20248,19305,0002020: 6,616 providers20202021: 7,343 providers20212022: 7,781 providers20222023: 8,062 providers20232024: 8,193 providers20248,19305,0002020: 6,616 providers20202021: 7,343 providers20212022: 7,781 providers20222023: 8,062 providers20232024: 8,193 providers20248,193

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
20248,193$333,464,072+12%286,125268719.60
20238,062$298,569,576+16%274,801268419.60
20227,781$257,888,980+20%261,929258319.60
20217,343$214,494,828+40%239,294248219.60
20206,616$152,710,063first year in data205,552247520.72

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
Florida523$18,611,96119,52126113
California495$15,143,62817,8162597
New York325$11,053,18711,1022587
Ohio311$10,366,4529,4632277
Illinois333$9,064,72610,9742676
Texas366$8,507,75911,0852179
Pennsylvania304$8,129,8329,7432476
Arizona197$7,239,2937,1482988
Michigan239$7,112,0226,3922161
Georgia176$7,053,7855,9862271
North Carolina291$6,759,3428,7882381
Virginia199$6,027,2777,7513093
Maryland154$5,668,5005,4452784
New Jersey177$5,362,5726,38324104
Tennessee162$5,359,9045,2402367

Not listed: 2 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-NJ284$9,356,14010,45226
Chicago-Naperville-Elgin, IL-IN236$7,156,1658,38227
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD124$5,172,8265,54636
Atlanta-Sandy Springs-Roswell, GA80$4,921,0162,92522
Boston-Cambridge-Newton, MA-NH138$4,871,4155,31729
Washington-Arlington-Alexandria, DC-VA-MD-WV115$4,381,4354,29828
Los Angeles-Long Beach-Anaheim, CA118$4,343,6395,07527
Phoenix-Mesa-Chandler, AZ138$3,920,1894,92229
Miami-Fort Lauderdale-West Palm Beach, FL93$3,480,7683,59021
Detroit-Warren-Dearborn, MI94$3,422,8252,72525
Columbus, OH53$3,049,6372,15034
Dallas-Fort Worth-Arlington, TX113$2,760,9933,60823
Minneapolis-St. Paul-Bloomington, MN-WI101$2,698,1722,38918
Baltimore-Columbia-Towson, MD90$2,517,2713,24728
Indianapolis-Carmel-Greenwood, IN79$2,487,6772,53322

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 95 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 27130 nationally

Orthopedic Surgery accounts for 69% of payment for 27130 nationally in 2021, across 6 specialties on claims.

observed calculated calculated calculated calculated calculated
Orthopedic Surgery4,32759%$148,356,58069%145,88734
Ambulatory Surgical Center2082.8%$53,057,51025%7,78737
Physician Assistant2,44733%$10,661,0305.0%74,78231
Nurse Practitioner3024.1%$1,262,1700.59%9,13530
Sports Medicine230.31%$622,5090.29%58425
General Surgery120.16%$117,7920.05%37131

Not listed: 9 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 27130 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