HCPCS 43239
Procedure (ClaimLight category; the code descriptor is not shown)
Procedures Work RVU per service 2.39 (2020 fee schedule)
Trend
Medicare payment on the code
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.
Billers
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 | |
|---|---|---|---|---|---|---|---|
| 2024 | 17,191 | $209,306,859 | +4% | 1,596,641 | 60 | 271 | 2.39 |
| 2023 | 17,140 | $201,872,979 | -5% | 1,603,452 | 61 | 277 | 2.39 |
| 2022 | 17,093 | $212,795,258 | -6% | 1,635,009 | 63 | 279 | 2.39 |
| 2021 | 17,240 | $225,489,880 | +14% | 1,714,975 | 65 | 294 | 2.39 |
| 2020 | 16,773 | $197,171,247 | first year in data | 1,531,820 | 60 | 266 | 2.39 |
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 | |
|---|---|---|---|---|---|---|
| California | 1,460 | $22,863,249 | 147,475 | 67 | 315 | |
| Florida | 1,220 | $21,503,139 | 163,810 | 85 | 425 | |
| New York | 1,211 | $15,430,604 | 86,255 | 47 | 198 | |
| Texas | 1,129 | $13,320,295 | 110,742 | 67 | 262 | |
| New Jersey | 612 | $9,904,234 | 58,749 | 66 | 290 | |
| Pennsylvania | 860 | $8,296,863 | 64,212 | 54 | 210 | |
| North Carolina | 552 | $7,030,039 | 55,839 | 63 | 315 | |
| Illinois | 643 | $6,330,045 | 56,541 | 64 | 229 | |
| Georgia | 481 | $6,109,967 | 47,586 | 67 | 288 | |
| Ohio | 680 | $6,087,735 | 52,208 | 52 | 215 | |
| Maryland | 356 | $6,033,782 | 41,335 | 76 | 367 | |
| Arizona | 336 | $4,793,566 | 34,301 | 62 | 344 | |
| South Carolina | 277 | $4,594,445 | 37,652 | 84 | 410 | |
| Michigan | 506 | $4,554,893 | 38,662 | 49 | 235 | |
| Tennessee | 365 | $4,409,564 | 38,339 | 71 | 287 |
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-NJ | 1,332 | $19,533,876 | 102,675 | 50 | |
| Los Angeles-Long Beach-Anaheim, CA | 538 | $7,834,480 | 51,486 | 62 | |
| Philadelphia-Camden-Wilmington, PA-NJ-DE-MD | 441 | $4,947,820 | 34,665 | 57 | |
| Chicago-Naperville-Elgin, IL-IN | 480 | $4,153,808 | 38,969 | 66 | |
| Miami-Fort Lauderdale-West Palm Beach, FL | 322 | $4,134,786 | 28,963 | 53 | |
| Dallas-Fort Worth-Arlington, TX | 339 | $3,680,363 | 30,915 | 65 | |
| Washington-Arlington-Alexandria, DC-VA-MD-WV | 298 | $3,607,089 | 26,509 | 61 | |
| Atlanta-Sandy Springs-Roswell, GA | 270 | $3,396,918 | 24,821 | 65 | |
| Phoenix-Mesa-Chandler, AZ | 234 | $3,315,465 | 23,532 | 60 | |
| Baltimore-Columbia-Towson, MD | 180 | $2,981,062 | 21,021 | 78 | |
| Houston-Pasadena-The Woodlands, TX | 273 | $2,925,748 | 22,884 | 59 | |
| San Francisco-Oakland-Fremont, CA | 177 | $2,762,206 | 15,802 | 64 | |
| Tampa-St. Petersburg-Clearwater, FL | 190 | $2,631,052 | 20,665 | 76 | |
| Detroit-Warren-Dearborn, MI | 213 | $2,435,880 | 19,507 | 65 | |
| Boston-Cambridge-Newton, MA-NH | 326 | $2,392,538 | 20,712 | 47 |
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 Center | 1,775 | 11% | $105,632,744 | 54% | 432,761 | 244 |
| Gastroenterology | 11,896 | 71% | $80,745,732 | 41% | 970,632 | 82 |
| General Surgery | 2,065 | 12% | $5,318,519 | 2.7% | 67,450 | 33 |
| Internal Medicine | 788 | 4.7% | $4,688,167 | 2.4% | 52,437 | 67 |
| Family Practice | 88 | 0.52% | $190,607 | 0.10% | 1,995 | 23 |
| Colorectal Surgery (Proctology) | 42 | 0.25% | $108,085 | 0.05% | 1,469 | 35 |
| Thoracic Surgery | 33 | 0.20% | $82,377 | 0.04% | 1,043 | 32 |
| General Practice | 21 | 0.13% | $74,485 | 0.04% | 708 | 34 |
| Vascular Surgery | 12 | 0.07% | $26,671 | 0.01% | 349 | 29 |
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