HCPCS 63685

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

Procedures Work RVU per service 5.19 (2022 fee schedule)

1,177
87th percentile among 6,326 codes billed · 2022
$189M
99th percentile among 6,326 codes billed · 2022
26K
75th percentile among 6,326 codes billed · 2022
17
30th percentile among 6,326 codes billed · 2022
46
36th percentile among 6,326 codes billed · 2022
+6.6%
Medicare payment on the code vs 2021; billers +5.0% · 2022

Trend

Medicare payment on the code

$0$100M$200M2020: $160M paid20202021: $178M paid20212022: $189M paid20222023: $216M paid20232024: $217M paid2024$217M$0$100M$200M2020: $160M paid20202021: $178M paid20212022: $189M paid20222023: $216M paid20232024: $217M paid2024$217M$0$100M$200M2020: $160M paid20202021: $178M paid20212022: $189M paid20222023: $216M paid20232024: $217M paid2024$217M$0$100M$200M2020: $160M paid20202021: $178M paid20212022: $189M paid20222023: $216M paid20232024: $217M paid2024$217M

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

Billers

05001,0002020: 1,101 providers20202021: 1,121 providers20212022: 1,177 providers20222023: 1,281 providers20232024: 1,210 providers20241,21005001,0002020: 1,101 providers20202021: 1,121 providers20212022: 1,177 providers20222023: 1,281 providers20232024: 1,210 providers20241,21005001,0002020: 1,101 providers20202021: 1,121 providers20212022: 1,177 providers20222023: 1,281 providers20232024: 1,210 providers20241,21005001,0002020: 1,101 providers20202021: 1,121 providers20212022: 1,177 providers20222023: 1,281 providers20232024: 1,210 providers20241,210

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
20241,210$217,454,221+1%27,09817505.19
20231,281$215,549,513+14%28,19217495.19
20221,177$189,375,294+7%25,57117465.19
20211,121$177,608,619+11%25,14117495.19
20201,101$159,998,315first year in data23,96317475.19

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
Texas140$34,096,8333,8592161
California78$17,253,5101,7131946
Florida97$12,735,8462,0021833
Arizona63$11,957,8991,2061635
Indiana41$7,443,9758141931
Maryland25$5,976,7566051850
Georgia45$5,605,1537151525
Minnesota28$5,574,5506741951
Tennessee37$5,537,5819031843
Nevada22$5,288,2915262241
Pennsylvania41$5,182,4429191650
Mississippi18$5,176,5837263281
Oregon23$5,092,1885112153
South Carolina38$4,878,1329111848
North Carolina37$4,663,9809742154

Not listed: 18 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
Phoenix-Mesa-Chandler, AZ47$9,478,47887016
Austin-Round Rock-San Marcos, TX27$8,816,69786821
San Antonio-New Braunfels, TX21$5,924,10182327
Dallas-Fort Worth-Arlington, TX27$5,057,33845914
Houston-Pasadena-The Woodlands, TX18$4,764,96950419
Minneapolis-St. Paul-Bloomington, MN-WI20$4,702,27149119
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD21$4,549,19649116
Las Vegas-Henderson-North Las Vegas, NV18$4,288,68043724
Indianapolis-Carmel-Greenwood, IN20$3,630,63640318
Fresno, CA14$3,555,11039622
New York-Newark-Jersey City, NY-NJ25$3,502,97441916
Chicago-Naperville-Elgin, IL-IN25$3,383,90839113
Kansas City, MO-KS18$3,118,93640517
Baltimore-Columbia-Towson, MD17$2,828,30033016
Memphis, TN-MS-AR12$2,135,06628214

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 21 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 63685 nationally

Ambulatory Surgical Center accounts for 99% of payment for 63685 nationally in 2022, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Ambulatory Surgical Center39534%$187,035,28699%10,01325
Neurosurgery19416%$721,7460.38%4,11021
Pain Management15613%$447,8310.24%2,75718
Anesthesiology1058.9%$363,4760.19%2,25521
Interventional Pain Management1069.0%$314,4990.17%1,89618
Orthopedic Surgery786.6%$268,7380.14%1,57820
Physical Medicine and Rehabilitation332.8%$133,1270.07%83325
Physician Assistant746.3%$39,6310.02%1,52521
Nurse Practitioner191.6%$9,443<0.01%35519

Not listed: 9 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 63685 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