HCPCS 45385

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

Procedures Work RVU per service 4.57 (2020 fee schedule)

14,759
98th percentile among 6,116 codes billed · 2020
$291M
99th percentile among 6,116 codes billed · 2020
1.1M
96th percentile among 6,116 codes billed · 2020
44
73rd percentile among 6,116 codes billed · 2020
219
71st percentile among 6,116 codes billed · 2020

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
California1,260$28,883,13191,74442212
Florida1,032$24,786,61890,62647297
Texas1,008$20,005,49576,68044226
North Carolina503$14,424,17353,82965293
Pennsylvania785$14,063,09752,20142203
New York918$13,361,15243,65231136
Ohio614$10,983,73443,18345206
Illinois562$10,275,22240,12449173
Georgia413$8,651,68832,44546248
New Jersey513$8,626,16728,24733180
Washington361$8,208,93729,51650253
Maryland325$7,849,92327,14250290
South Carolina248$7,295,39928,66472361
Indiana349$7,286,96029,66250233
Michigan462$7,161,77127,76436189

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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ989$15,485,43447,78630
Los Angeles-Long Beach-Anaheim, CA421$7,198,99723,48135
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD397$7,144,46324,82537
Chicago-Naperville-Elgin, IL-IN422$6,413,99125,61246
Dallas-Fort Worth-Arlington, TX329$6,303,73722,92340
Boston-Cambridge-Newton, MA-NH304$4,862,53918,88642
Atlanta-Sandy Springs-Roswell, GA234$4,484,60516,04740
Washington-Arlington-Alexandria, DC-VA-MD-WV262$4,451,53715,66338
Phoenix-Mesa-Chandler, AZ199$4,337,02415,18438
Miami-Fort Lauderdale-West Palm Beach, FL254$4,212,94514,82632
Baltimore-Columbia-Towson, MD160$4,024,28814,06556
San Francisco-Oakland-Fremont, CA155$3,901,64611,06452
Seattle-Tacoma-Bellevue, WA195$3,299,77611,80541
Indianapolis-Carmel-Greenwood, IN137$3,268,35111,90050
Charlotte-Concord-Gastonia, NC-SC114$3,148,39611,56872

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 45385 nationally

Ambulatory Surgical Center accounts for 48% of payment for 45385 nationally in 2020, across 7 specialties on claims.

observed calculated calculated calculated calculated calculated
Ambulatory Surgical Center1,73112%$140,713,54248%358,678207
Gastroenterology10,49071%$133,150,63246%643,03261
General Surgery1,3148.9%$6,986,6492.4%35,66627
Internal Medicine5994.1%$6,477,8292.2%31,05352
Colorectal Surgery (Proctology)4843.3%$3,084,6001.1%15,59832
Family Practice920.62%$464,2830.16%2,24024
General Practice110.07%$102,3860.04%46242

Not listed: 16 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 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