HCPCS 90960

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

Other services Work RVU per service 6.77 (2023 fee schedule)

6,549
96th percentile among 6,405 codes billed · 2023
$333M
99th percentile among 6,405 codes billed · 2023
1.2M
96th percentile among 6,405 codes billed · 2023
153
90th percentile among 6,405 codes billed · 2023
427
78th percentile among 6,405 codes billed · 2023
-14.6%
Medicare payment on the code vs 2022; billers -3.9% · 2023

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
California624$45,801,021156,218214640
Texas617$32,013,549118,012166401
New York437$25,647,94584,667160464
Florida462$21,169,24976,070142386
Illinois298$15,349,30754,456158450
Pennsylvania296$12,518,79444,920129335
New Jersey238$12,428,84241,954157413
North Carolina261$12,244,43845,857169384
Georgia241$11,956,30144,289170398
Maryland157$11,774,78840,313253469
Michigan202$10,122,73736,969164388
Virginia180$8,797,48931,843153347
Ohio220$7,157,04226,697104299
South Carolina129$6,924,79526,024181457
Tennessee134$6,575,40025,348169467

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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ479$26,820,33686,580155
Los Angeles-Long Beach-Anaheim, CA260$18,509,20962,729191
Chicago-Naperville-Elgin, IL-IN254$13,049,43246,163154
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD187$9,479,08432,846145
Dallas-Fort Worth-Arlington, TX181$8,647,49631,310153
Washington-Arlington-Alexandria, DC-VA-MD-WV127$8,502,78428,640197
Houston-Pasadena-The Woodlands, TX148$6,444,38223,345145
Baltimore-Columbia-Towson, MD83$5,962,75820,408254
San Francisco-Oakland-Fremont, CA80$5,687,76217,974220
Miami-Fort Lauderdale-West Palm Beach, FL128$5,621,62919,753137
Atlanta-Sandy Springs-Roswell, GA124$5,598,39720,480156
Riverside-San Bernardino-Ontario, CA82$4,842,63517,064218
Detroit-Warren-Dearborn, MI101$4,737,99716,921143
Boston-Cambridge-Newton, MA-NH72$4,055,88014,101126
San Antonio-New Braunfels, TX72$3,730,68014,123196

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 86 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 90960 nationally

Nephrology accounts for 89% of payment for 90960 nationally in 2023, across 6 specialties on claims.

observed calculated calculated calculated calculated calculated
Nephrology5,50984%$295,580,50089%1,060,068192
Internal Medicine5879.0%$30,435,0969.1%109,361186
Nurse Practitioner3224.9%$3,074,5340.92%13,22241
Neurology310.47%$1,477,6840.44%5,249169
Hospitalist210.32%$1,019,3810.31%3,694176
Physician Assistant500.76%$294,6330.09%1,26725

Not listed: 13 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 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