HCPCS 45385

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

Procedures Work RVU per service 4.57 (2022 fee schedule)

15,913
98th percentile among 6,326 codes billed · 2022
$381M
99th percentile among 6,326 codes billed · 2022
1.4M
96th percentile among 6,326 codes billed · 2022
53
76th percentile among 6,326 codes billed · 2022
262
73rd percentile among 6,326 codes billed · 2022
+4.5%
Medicare payment on the code vs 2021; billers +1.4% · 2022

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
California1,348$40,718,907127,50456301
Florida1,107$31,343,223112,44753388
Texas1,123$26,525,548100,59853258
New York1,068$19,649,29862,37136161
Pennsylvania850$18,824,41069,13350237
North Carolina548$17,368,69563,59667348
Illinois612$13,758,73653,80461225
Ohio635$13,688,65752,95051242
New Jersey561$12,175,10339,99343207
Maryland353$11,338,54338,44969363
Georgia452$11,153,15940,96556298
Washington375$10,861,22438,50167278
Massachusetts438$9,879,59738,63164225
Indiana367$9,056,59136,45164258
Michigan505$8,997,71935,20242186

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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,152$23,058,70570,41237
Los Angeles-Long Beach-Anaheim, CA445$10,498,04033,75746
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD425$10,375,00135,74551
Chicago-Naperville-Elgin, IL-IN457$9,321,18837,39261
Dallas-Fort Worth-Arlington, TX352$8,240,41929,40146
Washington-Arlington-Alexandria, DC-VA-MD-WV297$7,919,51726,54153
Boston-Cambridge-Newton, MA-NH342$7,578,47529,25658
Miami-Fort Lauderdale-West Palm Beach, FL290$6,325,41522,02941
Atlanta-Sandy Springs-Roswell, GA266$6,147,90221,67549
San Francisco-Oakland-Fremont, CA173$6,014,46817,03367
Phoenix-Mesa-Chandler, AZ233$5,969,04020,44445
Baltimore-Columbia-Towson, MD170$5,057,12517,55463
Seattle-Tacoma-Bellevue, WA206$4,620,49716,26957
Indianapolis-Carmel-Greenwood, IN145$4,268,94015,39666
Houston-Pasadena-The Woodlands, TX273$4,204,50816,00841

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 2022.

Specialties billing 45385 nationally

Ambulatory Surgical Center accounts for 50% of payment for 45385 nationally in 2022, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Ambulatory Surgical Center1,75011%$192,517,95950%465,745266
Gastroenterology11,22071%$166,700,72144%826,76974
Internal Medicine7064.4%$8,612,7652.3%42,36260
General Surgery1,5009.4%$8,532,9362.2%45,18830
Colorectal Surgery (Proctology)5553.5%$3,838,6801.0%19,78536
Family Practice1120.70%$559,0980.15%2,90126
Hospitalist160.10%$145,0440.04%69243
General Practice130.08%$120,1390.03%57444

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 2022.

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