HCPCS 45385

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

Procedures Work RVU per service 4.57 (2024 fee schedule)

16,464
98th percentile among 6,471 codes billed · 2024
$457M
99th percentile among 6,471 codes billed · 2024
1.5M
97th percentile among 6,471 codes billed · 2024
56
74th percentile among 6,471 codes billed · 2024
273
71st percentile among 6,471 codes billed · 2024
+7.0%
Medicare payment on the code vs 2023; billers +0.9% · 2024

Trend

Medicare payment on the code

$0$200M$400M2020: $291M paid20202021: $365M paid20212022: $381M paid20222023: $427M paid20232024: $457M paid2024$457M$0$200M$400M2020: $291M paid20202021: $365M paid20212022: $381M paid20222023: $427M paid20232024: $457M paid2024$457M$0$200M$400M2020: $291M paid20202021: $365M paid20212022: $381M paid20222023: $427M paid20232024: $457M paid2024$457M$0$200M$400M2020: $291M paid20202021: $365M paid20212022: $381M paid20222023: $427M paid20232024: $457M paid2024$457M

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

Billers

010K2020: 15K providers20202021: 16K providers20212022: 16K providers20222023: 16K providers20232024: 16K providers202416K010K2020: 15K providers20202021: 16K providers20212022: 16K providers20222023: 16K providers20232024: 16K providers202416K010K2020: 15K providers20202021: 16K providers20212022: 16K providers20222023: 16K providers20232024: 16K providers202416K010K2020: 15K 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
202416,464$456,555,338+7%1,528,359562734.57
202316,310$426,638,634+12%1,487,316552694.57
202215,913$381,492,875+5%1,406,150532624.57
202115,699$365,003,434+25%1,341,942502544.57
202014,759$291,403,814first year in data1,088,627442194.57

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
California1,436$53,707,046150,76063329
Florida1,145$36,416,177118,69056382
Texas1,148$31,829,615107,08154257
Pennsylvania856$22,527,53476,18254254
New York1,104$22,198,58067,49937170
North Carolina558$19,264,06964,22670324
Ohio683$16,056,25457,09454259
New Jersey573$16,014,15646,85649246
Illinois668$15,741,48557,67356224
Maryland370$14,119,90743,01172392
Georgia461$12,901,00942,30957303
Washington387$12,113,40738,83663294
Massachusetts477$11,708,55343,63964238
South Carolina264$10,573,72237,08087451
Arizona330$10,263,30433,23154328

Not listed: 2 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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,185$27,893,84179,62438
Los Angeles-Long Beach-Anaheim, CA487$13,807,56640,90253
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD447$12,980,24740,54252
Chicago-Naperville-Elgin, IL-IN514$11,062,94041,83154
Dallas-Fort Worth-Arlington, TX358$10,265,31532,25750
Washington-Arlington-Alexandria, DC-VA-MD-WV311$9,936,93930,34859
Boston-Cambridge-Newton, MA-NH358$9,115,28532,85163
Phoenix-Mesa-Chandler, AZ256$8,092,18524,98051
San Francisco-Oakland-Fremont, CA177$7,747,15318,52768
Atlanta-Sandy Springs-Roswell, GA276$7,732,88123,95651
Miami-Fort Lauderdale-West Palm Beach, FL294$7,615,03723,64042
Baltimore-Columbia-Towson, MD182$6,639,96720,49563
Seattle-Tacoma-Bellevue, WA222$5,324,09917,06349
Houston-Pasadena-The Woodlands, TX290$5,183,12817,86440
San Jose-Sunnyvale-Santa Clara, CA114$5,105,32211,84243

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 2024.

Specialties billing 45385 nationally

Ambulatory Surgical Center accounts for 55% of payment for 45385 nationally in 2024, across 7 specialties on claims.

observed calculated calculated calculated calculated calculated
Ambulatory Surgical Center1,78711%$250,524,62455%509,054285
Gastroenterology11,54370%$180,810,85740%891,61077
Internal Medicine7724.7%$10,331,4682.3%50,63166
General Surgery1,5509.4%$9,134,8412.0%47,79531
Colorectal Surgery (Proctology)6153.7%$4,302,5390.94%22,07136
Family Practice1200.73%$671,1440.15%3,39828
Hospitalist240.15%$288,9050.06%1,40058

Not listed: 19 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 45385 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