HCPCS 90960

Other service (ClaimLight category; the code descriptor is not shown)

Other services Work RVU per service 5.18 (2020 fee schedule)

7,360
96th percentile among 6,116 codes billed · 2020
$495M
100th percentile among 6,116 codes billed · 2020
2.2M
97th percentile among 6,116 codes billed · 2020
239
93rd percentile among 6,116 codes billed · 2020
739
86th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$200M$400M2020: $495M paid20202021: $478M paid20212022: $390M paid20222023: $333M paid20232024: $297M paid2024$297M$0$200M$400M2020: $495M paid20202021: $478M paid20212022: $390M paid20222023: $333M paid20232024: $297M paid2024$297M$0$200M$400M2020: $495M paid20202021: $478M paid20212022: $390M paid20222023: $333M paid20232024: $297M paid2024$297M$0$200M$400M2020: $495M paid20202021: $478M paid20212022: $390M paid20222023: $333M paid20232024: $297M paid2024$297M

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

Billers

05,0002020: 7,360 providers20202021: 7,057 providers20212022: 6,814 providers20222023: 6,549 providers20232024: 6,383 providers20246,38305,0002020: 7,360 providers20202021: 7,057 providers20212022: 6,814 providers20222023: 6,549 providers20232024: 6,383 providers20246,38305,0002020: 7,360 providers20202021: 7,057 providers20212022: 6,814 providers20222023: 6,549 providers20232024: 6,383 providers20246,38305,0002020: 7,360 providers20202021: 7,057 providers20212022: 6,814 providers20222023: 6,549 providers20232024: 6,383 providers20246,383

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
20246,383$296,622,466-11%1,080,7131423966.77
20236,549$333,207,529-15%1,197,6331534276.77
20226,814$390,094,256-18%1,368,4571684766.77
20217,057$478,375,612-3%1,657,3341955726.77
20207,360$495,091,415first year in data2,151,8492397395.18

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
Texas685$54,309,502241,397311784
California664$53,308,184218,507273856
New York507$34,779,933138,543225703
Florida470$31,869,088136,907256724
Georgia277$24,337,642108,2203191,065
North Carolina280$23,065,949103,968347851
Illinois311$20,046,88285,629236661
Pennsylvania357$18,103,90478,436193446
New Jersey259$16,078,43165,568219540
Virginia197$14,940,83064,862294768
Michigan228$14,351,09363,209239620
Maryland162$13,552,72155,804332688
South Carolina140$12,604,09857,5453731,121
Ohio290$12,175,78154,360161518
Tennessee147$10,906,06350,448292815

Not listed: 1 billers with an armed-forces or unknown state code (ZZ); they are in the national totals.

Not listed: 6 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-NJ538$35,855,040139,228216
Los Angeles-Long Beach-Anaheim, CA270$21,272,09086,234258
Chicago-Naperville-Elgin, IL-IN267$17,341,68473,902234
Dallas-Fort Worth-Arlington, TX205$14,469,04063,838284
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD227$12,773,48653,475193
Houston-Pasadena-The Woodlands, TX168$11,489,23249,739248
Washington-Arlington-Alexandria, DC-VA-MD-WV135$11,278,34545,825313
Atlanta-Sandy Springs-Roswell, GA143$10,924,91547,799294
Miami-Fort Lauderdale-West Palm Beach, FL148$9,792,74440,884234
Baltimore-Columbia-Towson, MD90$7,162,17329,594317
Detroit-Warren-Dearborn, MI124$7,037,81330,195192
San Francisco-Oakland-Fremont, CA81$6,513,62925,135278
Riverside-San Bernardino-Ontario, CA78$6,016,11725,503293
San Antonio-New Braunfels, TX82$5,763,15726,078295
Charlotte-Concord-Gastonia, NC-SC56$4,914,90922,158403

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 91 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 90960 nationally

Nephrology accounts for 89% of payment for 90960 nationally in 2020, across 6 specialties on claims.

observed calculated calculated calculated calculated calculated
Nephrology6,15984%$439,343,93489%1,907,525310
Internal Medicine6318.6%$46,119,2289.3%198,848315
Nurse Practitioner4195.7%$3,625,5660.73%18,87445
Neurology350.48%$2,348,8950.47%10,169291
Hospitalist170.23%$896,3550.18%3,953233
Physician Assistant660.90%$661,4260.13%3,43752

Not listed: 15 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 90960 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