HCPCS 43239

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

Procedures Work RVU per service 2.39 (2023 fee schedule)

17,140
98th percentile among 6,405 codes billed · 2023
$202M
99th percentile among 6,405 codes billed · 2023
1.6M
97th percentile among 6,405 codes billed · 2023
61
78th percentile among 6,405 codes billed · 2023
277
72nd percentile among 6,405 codes billed · 2023
-5.1%
Medicare payment on the code vs 2022; billers +0.3% · 2023

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
California1,504$26,013,227171,14677359
Florida1,264$21,194,416168,58577446
New York1,293$18,300,229103,14350217
Texas1,209$13,620,840117,77268264
New Jersey609$11,286,25369,24079325
Pennsylvania883$8,501,60868,21254206
Maryland381$6,761,63848,12584434
Illinois676$6,489,02460,81866259
North Carolina562$6,208,45451,20658279
Ohio672$5,924,47051,82554228
Georgia491$5,847,98547,33966315
Arizona337$4,917,89036,71165360
South Carolina272$4,378,40837,14885404
Michigan508$4,187,98637,56451213
Massachusetts467$3,940,39534,10153192

Not listed: 3 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,399$23,416,150127,70858
Los Angeles-Long Beach-Anaheim, CA544$9,622,66664,72977
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD446$5,302,58839,28363
Washington-Arlington-Alexandria, DC-VA-MD-WV327$4,936,86134,61767
Chicago-Naperville-Elgin, IL-IN517$4,462,94743,69564
Miami-Fort Lauderdale-West Palm Beach, FL338$4,415,38333,23052
Dallas-Fort Worth-Arlington, TX357$3,955,20833,60566
Phoenix-Mesa-Chandler, AZ246$3,737,61027,01264
Atlanta-Sandy Springs-Roswell, GA279$3,461,74326,21462
San Francisco-Oakland-Fremont, CA178$3,275,14118,49370
Baltimore-Columbia-Towson, MD180$3,059,99922,58885
Houston-Pasadena-The Woodlands, TX310$3,038,28725,49156
Boston-Cambridge-Newton, MA-NH361$2,730,94823,90251
Tampa-St. Petersburg-Clearwater, FL199$2,600,66621,52871
Detroit-Warren-Dearborn, MI216$2,397,82419,96663

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 2023.

Specialties billing 43239 nationally

Ambulatory Surgical Center accounts for 56% of payment for 43239 nationally in 2023, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Ambulatory Surgical Center1,78310%$113,708,27556%468,938263
Gastroenterology12,33572%$78,197,98439%1,005,41382
Internal Medicine8515.0%$4,691,8612.3%57,96668
General Surgery1,91411%$4,494,7102.2%61,97832
Family Practice750.44%$146,7860.07%1,69723
Colorectal Surgery (Proctology)520.30%$112,1690.06%1,59531
Hospitalist220.13%$94,2780.05%1,21855
Thoracic Surgery320.19%$73,7340.04%96830
General Practice140.08%$51,5770.03%52838

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 2023.

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