HCPCS 43239

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

Procedures Work RVU per service 2.39 (2020 fee schedule)

16,773
98th percentile among 6,116 codes billed · 2020
$197M
99th percentile among 6,116 codes billed · 2020
1.5M
97th percentile among 6,116 codes billed · 2020
60
81st percentile among 6,116 codes billed · 2020
266
74th percentile among 6,116 codes billed · 2020

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
California1,460$22,863,249147,47567315
Florida1,220$21,503,139163,81085425
New York1,211$15,430,60486,25547198
Texas1,129$13,320,295110,74267262
New Jersey612$9,904,23458,74966290
Pennsylvania860$8,296,86364,21254210
North Carolina552$7,030,03955,83963315
Illinois643$6,330,04556,54164229
Georgia481$6,109,96747,58667288
Ohio680$6,087,73552,20852215
Maryland356$6,033,78241,33576367
Arizona336$4,793,56634,30162344
South Carolina277$4,594,44537,65284410
Michigan506$4,554,89338,66249235
Tennessee365$4,409,56438,33971287

Not listed: 1 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,332$19,533,876102,67550
Los Angeles-Long Beach-Anaheim, CA538$7,834,48051,48662
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD441$4,947,82034,66557
Chicago-Naperville-Elgin, IL-IN480$4,153,80838,96966
Miami-Fort Lauderdale-West Palm Beach, FL322$4,134,78628,96353
Dallas-Fort Worth-Arlington, TX339$3,680,36330,91565
Washington-Arlington-Alexandria, DC-VA-MD-WV298$3,607,08926,50961
Atlanta-Sandy Springs-Roswell, GA270$3,396,91824,82165
Phoenix-Mesa-Chandler, AZ234$3,315,46523,53260
Baltimore-Columbia-Towson, MD180$2,981,06221,02178
Houston-Pasadena-The Woodlands, TX273$2,925,74822,88459
San Francisco-Oakland-Fremont, CA177$2,762,20615,80264
Tampa-St. Petersburg-Clearwater, FL190$2,631,05220,66576
Detroit-Warren-Dearborn, MI213$2,435,88019,50765
Boston-Cambridge-Newton, MA-NH326$2,392,53820,71247

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 2020.

Specialties billing 43239 nationally

Ambulatory Surgical Center accounts for 54% of payment for 43239 nationally in 2020, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Ambulatory Surgical Center1,77511%$105,632,74454%432,761244
Gastroenterology11,89671%$80,745,73241%970,63282
General Surgery2,06512%$5,318,5192.7%67,45033
Internal Medicine7884.7%$4,688,1672.4%52,43767
Family Practice880.52%$190,6070.10%1,99523
Colorectal Surgery (Proctology)420.25%$108,0850.05%1,46935
Thoracic Surgery330.20%$82,3770.04%1,04332
General Practice210.13%$74,4850.04%70834
Vascular Surgery120.07%$26,6710.01%34929

Not listed: 23 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 2020.

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