HCPCS 45385

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

Procedures Work RVU per service 4.57 (2023 fee schedule)

16,310
98th percentile among 6,405 codes billed · 2023
$427M
99th percentile among 6,405 codes billed · 2023
1.5M
97th percentile among 6,405 codes billed · 2023
55
76th percentile among 6,405 codes billed · 2023
269
72nd percentile among 6,405 codes billed · 2023
+11.8%
Medicare payment on the code vs 2022; billers +2.5% · 2023

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
California1,407$47,698,137140,12259294
Florida1,135$35,178,757119,57655383
Texas1,129$29,796,404105,08553258
New York1,103$21,446,11966,48638168
Pennsylvania860$20,877,61672,64049247
North Carolina557$18,621,00164,68668322
Ohio674$15,456,88656,79254253
Illinois635$14,879,65555,61660212
New Jersey562$14,276,46044,23750231
Maryland359$12,796,93140,89075373
Georgia469$12,492,79243,03155304
Washington375$11,612,27439,19372273
Massachusetts463$11,030,57541,46062249
Indiana374$9,896,59637,73560271
South Carolina267$9,843,49436,43685427

Not listed: 4 billers with an armed-forces or unknown state code (AP, 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-NJ1,174$26,214,19077,55140
Los Angeles-Long Beach-Anaheim, CA483$12,513,08538,21650
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD437$11,781,10038,37051
Chicago-Naperville-Elgin, IL-IN478$10,274,18639,51361
Dallas-Fort Worth-Arlington, TX362$9,454,89331,20249
Washington-Arlington-Alexandria, DC-VA-MD-WV311$9,323,66929,65856
Boston-Cambridge-Newton, MA-NH360$8,508,82531,53360
Atlanta-Sandy Springs-Roswell, GA278$7,251,15823,74650
Phoenix-Mesa-Chandler, AZ254$7,174,77723,22847
Miami-Fort Lauderdale-West Palm Beach, FL293$7,132,30623,28838
San Francisco-Oakland-Fremont, CA174$6,424,18416,58963
Baltimore-Columbia-Towson, MD169$5,889,07119,28175
Seattle-Tacoma-Bellevue, WA203$5,148,45717,27362
Indianapolis-Carmel-Greenwood, IN157$4,723,17516,13163
Houston-Pasadena-The Woodlands, TX276$4,656,89016,79643

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 2023.

Specialties billing 45385 nationally

Ambulatory Surgical Center accounts for 52% of payment for 45385 nationally in 2023, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Ambulatory Surgical Center1,78911%$223,133,26252%493,121276
Gastroenterology11,43070%$178,886,06942%870,90476
Internal Medicine7614.7%$9,773,0562.3%47,42562
General Surgery1,5439.5%$9,138,7612.1%47,48831
Colorectal Surgery (Proctology)6023.7%$4,333,8301.0%21,76436
Family Practice1140.70%$621,8530.15%3,09127
Hospitalist190.12%$222,2560.05%1,02854
General Practice110.07%$110,8610.03%52548

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 2023.

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