HCPCS 43239

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

Procedures Work RVU per service 2.39 (2024 fee schedule)

17,191
98th percentile among 6,471 codes billed · 2024
$209M
99th percentile among 6,471 codes billed · 2024
1.6M
97th percentile among 6,471 codes billed · 2024
60
76th percentile among 6,471 codes billed · 2024
271
71st percentile among 6,471 codes billed · 2024
+3.7%
Medicare payment on the code vs 2023; billers +0.3% · 2024

Trend

Medicare payment on the code

$0$100M$200M2020: $197M paid20202021: $225M paid20212022: $213M paid20222023: $202M paid20232024: $209M paid2024$209M$0$100M$200M2020: $197M paid20202021: $225M paid20212022: $213M paid20222023: $202M paid20232024: $209M paid2024$209M$0$100M$200M2020: $197M paid20202021: $225M paid20212022: $213M paid20222023: $202M paid20232024: $209M paid2024$209M$0$100M$200M2020: $197M paid20202021: $225M paid20212022: $213M paid20222023: $202M paid20232024: $209M paid2024$209M

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

Billers

010K2020: 17K providers20202021: 17K providers20212022: 17K providers20222023: 17K providers20232024: 17K providers202417K010K2020: 17K providers20202021: 17K providers20212022: 17K providers20222023: 17K providers20232024: 17K providers202417K010K2020: 17K providers20202021: 17K providers20212022: 17K providers20222023: 17K providers20232024: 17K providers202417K010K2020: 17K providers20202021: 17K providers20212022: 17K providers20222023: 17K providers20232024: 17K providers202417K

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
202417,191$209,306,859+4%1,596,641602712.39
202317,140$201,872,979-5%1,603,452612772.39
202217,093$212,795,258-6%1,635,009632792.39
202117,240$225,489,880+14%1,714,975652942.39
202016,773$197,171,247first year in data1,531,820602662.39

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
California1,526$28,493,143178,61976373
Florida1,276$21,360,980163,73775425
New York1,280$17,944,243100,72850207
Texas1,211$14,374,020117,77567251
New Jersey618$11,745,15369,13176326
Pennsylvania860$8,701,72767,79656213
Maryland381$7,031,24047,28880413
Illinois703$6,613,91060,66462240
North Carolina558$6,370,90150,20262268
Ohio708$6,367,16454,00952222
Georgia493$6,166,18347,32763301
Arizona346$5,148,43236,75265365
South Carolina275$4,615,55437,52688371
Massachusetts474$4,094,48935,25554194
Michigan483$4,086,43035,60350225

Not listed: 4 billers with an armed-forces or unknown state code (ZZ); they are in the national totals.

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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,393$23,354,037125,25957
Los Angeles-Long Beach-Anaheim, CA549$10,340,88467,13575
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD440$5,586,15439,60666
Washington-Arlington-Alexandria, DC-VA-MD-WV327$5,191,12634,56367
Chicago-Naperville-Elgin, IL-IN549$4,652,85844,42062
Miami-Fort Lauderdale-West Palm Beach, FL335$4,459,40232,22448
Dallas-Fort Worth-Arlington, TX365$4,188,11933,72465
Phoenix-Mesa-Chandler, AZ259$3,987,38527,61365
San Francisco-Oakland-Fremont, CA182$3,803,85119,86875
Atlanta-Sandy Springs-Roswell, GA286$3,734,99026,63759
Baltimore-Columbia-Towson, MD189$3,200,19722,32773
Houston-Pasadena-The Woodlands, TX310$3,168,82825,55756
Boston-Cambridge-Newton, MA-NH362$2,893,36924,76550
Tampa-St. Petersburg-Clearwater, FL191$2,463,82119,69872
Detroit-Warren-Dearborn, MI199$2,404,60118,72164

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 98 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2024.

Specialties billing 43239 nationally

Ambulatory Surgical Center accounts for 59% of payment for 43239 nationally in 2024, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Ambulatory Surgical Center1,78010%$124,021,14859%467,744263
Gastroenterology12,46072%$75,587,89936%1,000,18580
Internal Medicine8695.1%$4,737,9842.3%59,99369
General Surgery1,83611%$4,212,2652.0%59,36532
Hospitalist240.14%$128,4560.06%1,69271
Family Practice700.41%$122,2240.06%1,58223
Colorectal Surgery (Proctology)520.30%$118,1070.06%1,70933
Thoracic Surgery300.17%$63,4580.03%84028

Not listed: 25 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 2024.

Top billers of 43239 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