HCPCS 45380

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

Procedures Work RVU per service 3.56 (2021 fee schedule)

16,397
98th percentile among 6,253 codes billed · 2021
$251M
99th percentile among 6,253 codes billed · 2021
1.3M
96th percentile among 6,253 codes billed · 2021
49
74th percentile among 6,253 codes billed · 2021
247
72nd percentile among 6,253 codes billed · 2021
+20.3%
Medicare payment on the code vs 2020; billers +4.7% · 2021

Trend

Medicare payment on the code

$0$100M$200M2020: $209M paid20202021: $251M paid20212022: $242M paid20222023: $249M paid20232024: $247M paid2024$247M$0$100M$200M2020: $209M paid20202021: $251M paid20212022: $242M paid20222023: $249M paid20232024: $247M paid2024$247M$0$100M$200M2020: $209M paid20202021: $251M paid20212022: $242M paid20222023: $249M paid20232024: $247M paid2024$247M$0$100M$200M2020: $209M paid20202021: $251M paid20212022: $242M paid20222023: $249M paid20232024: $247M paid2024$247M

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

Billers

010K2020: 16K providers20202021: 16K providers20212022: 16K providers20222023: 16K providers20232024: 16K providers202416K010K2020: 16K providers20202021: 16K providers20212022: 16K providers20222023: 16K providers20232024: 16K providers202416K010K2020: 16K providers20202021: 16K providers20212022: 16K providers20222023: 16K providers20232024: 16K providers202416K010K2020: 16K providers20202021: 16K providers20212022: 16K providers20222023: 16K providers20232024: 16K providers202416K

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
202416,278$247,476,024-1%1,249,030442363.56
202316,427$249,156,906+3%1,301,033462443.56
202216,256$242,022,657-4%1,318,857482473.56
202116,397$250,918,771+20%1,349,086492473.56
202015,662$208,596,658first year in data1,145,510442253.56

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
California1,420$31,727,324142,94960320
Florida1,122$21,372,341111,78055327
Texas1,134$18,777,198100,91352262
New York1,193$18,114,32278,74939188
New Jersey597$11,552,39251,74856264
Pennsylvania863$10,536,29259,71545213
Maryland358$9,463,62743,92675557
Illinois656$8,689,61854,88857224
North Carolina525$8,105,55345,12354274
Arizona346$7,718,25937,29359378
Ohio660$6,913,20242,57241179
Georgia462$6,779,57436,02250241
Washington376$6,537,48035,73059300
Massachusetts450$5,677,20934,76754202
Tennessee333$5,274,66228,89146258

Not listed: 1 billers with an armed-forces or unknown state code (ZZ); they are in the national totals.

Not listed: 3 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-NJ1,297$22,169,93093,00343
Los Angeles-Long Beach-Anaheim, CA511$10,466,99145,33551
Washington-Arlington-Alexandria, DC-VA-MD-WV314$7,032,43533,95268
Dallas-Fort Worth-Arlington, TX380$6,965,83735,09756
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD445$6,631,72233,80146
Phoenix-Mesa-Chandler, AZ254$6,259,44329,17962
Chicago-Naperville-Elgin, IL-IN484$5,955,45039,64860
San Francisco-Oakland-Fremont, CA183$4,741,95118,91858
Houston-Pasadena-The Woodlands, TX278$4,382,08823,05549
Atlanta-Sandy Springs-Roswell, GA266$4,320,79321,43852
Boston-Cambridge-Newton, MA-NH353$4,147,17425,98753
Baltimore-Columbia-Towson, MD178$4,094,32719,37861
Seattle-Tacoma-Bellevue, WA204$3,721,89719,44160
Miami-Fort Lauderdale-West Palm Beach, FL286$3,648,04518,76934
Detroit-Warren-Dearborn, MI214$2,745,58915,18836

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 100 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 45380 nationally

Ambulatory Surgical Center accounts for 59% of payment for 45380 nationally in 2021, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Ambulatory Surgical Center1,77511%$149,271,56459%437,778247
Gastroenterology11,48770%$87,633,10435%793,59669
General Surgery1,5859.7%$5,867,7242.3%49,52931
Internal Medicine7184.4%$4,579,1021.8%38,92854
Colorectal Surgery (Proctology)5743.5%$2,448,7720.98%21,06637
Family Practice1841.1%$611,8700.24%4,48324
General Practice140.09%$87,0180.03%50536
Hospitalist120.07%$63,9900.03%65254

Not listed: 18 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 45380 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