HCPCS 96413

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

Other services Work RVU per service 0.28 (2024 fee schedule)

7,637
96th percentile among 6,471 codes billed · 2024
$161M
98th percentile among 6,471 codes billed · 2024
1.6M
97th percentile among 6,471 codes billed · 2024
148
88th percentile among 6,471 codes billed · 2024
620
81st percentile among 6,471 codes billed · 2024
+0.3%
Medicare payment on the code vs 2023; billers +1.6% · 2024

Trend

Medicare payment on the code

$0$100M$200M2020: $195M paid20202021: $187M paid20212022: $166M paid20222023: $160M paid20232024: $161M paid2024$161M$0$100M$200M2020: $195M paid20202021: $187M paid20212022: $166M paid20222023: $160M paid20232024: $161M paid2024$161M$0$100M$200M2020: $195M paid20202021: $187M paid20212022: $166M paid20222023: $160M paid20232024: $161M paid2024$161M$0$100M$200M2020: $195M paid20202021: $187M paid20212022: $166M paid20222023: $160M paid20232024: $161M paid2024$161M

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

Billers

05,0002020: 7,264 providers20202021: 7,210 providers20212022: 7,300 providers20222023: 7,514 providers20232024: 7,637 providers20247,63705,0002020: 7,264 providers20202021: 7,210 providers20212022: 7,300 providers20222023: 7,514 providers20232024: 7,637 providers20247,63705,0002020: 7,264 providers20202021: 7,210 providers20212022: 7,300 providers20222023: 7,514 providers20232024: 7,637 providers20247,63705,0002020: 7,264 providers20202021: 7,210 providers20212022: 7,300 providers20222023: 7,514 providers20232024: 7,637 providers20247,637

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
20247,637$160,936,500+0%1,637,3251486200.28
20237,514$160,478,106-4%1,591,5661466250.28
20227,300$166,447,793-11%1,550,1931476190.28
20217,210$187,397,792-4%1,622,3601596590.28
20207,264$195,032,293first year in data1,768,3251727130.28

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
Florida756$19,707,013204,769198772
California648$16,794,188143,501158582
Texas836$15,959,254167,626146535
Illinois389$7,135,21072,663123557
Maryland244$6,715,57361,825202687
Virginia245$6,638,32266,605236654
New York353$6,467,26459,828127436
New Jersey227$6,052,03553,810193676
Arizona234$6,025,05661,661189811
Pennsylvania280$5,409,43953,174136543
Tennessee262$4,587,28752,460140563
North Carolina279$4,187,98245,39587452
South Carolina152$3,969,41243,302208857
Georgia159$3,675,40039,881174737
Ohio209$3,599,47539,635131505

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

Not listed: 9 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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ329$7,676,34266,283142
Los Angeles-Long Beach-Anaheim, CA281$6,560,63156,340152
Chicago-Naperville-Elgin, IL-IN288$5,327,50252,959124
Washington-Arlington-Alexandria, DC-VA-MD-WV210$4,882,43144,281170
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD212$4,871,79845,328169
Dallas-Fort Worth-Arlington, TX293$4,585,41948,191130
Phoenix-Mesa-Chandler, AZ171$4,272,66743,793185
Baltimore-Columbia-Towson, MD117$3,434,07632,137212
Miami-Fort Lauderdale-West Palm Beach, FL154$3,402,74333,167132
Houston-Pasadena-The Woodlands, TX174$3,106,37131,783129
Tampa-St. Petersburg-Clearwater, FL134$2,929,74131,409166
San Antonio-New Braunfels, TX105$2,320,00224,627141
North Port-Bradenton-Sarasota, FL63$2,123,39822,638335
San Francisco-Oakland-Fremont, CA85$2,067,80015,326146
Virginia Beach-Chesapeake-Norfolk, VA-NC80$2,021,23720,658204

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 95 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2024.

Specialties billing 96413 nationally

Hematology-Oncology accounts for 46% of payment for 96413 nationally in 2024, across 19 specialties on claims.

observed calculated calculated calculated calculated calculated
Hematology-Oncology2,60934%$73,727,11746%740,501284
Rheumatology1,56120%$41,582,49426%419,778269
Medical Oncology86311%$21,135,46413%213,989248
Nurse Practitioner95112%$6,717,3834.2%81,23285
Internal Medicine3284.3%$5,989,9623.7%60,532185
Neurology2152.8%$2,693,0341.7%27,661129
Hematology891.2%$1,995,1571.2%19,115215
Gastroenterology4666.1%$1,688,7011.0%17,46537
Physician Assistant1772.3%$1,194,7460.74%14,23680
Gynecological Oncology710.93%$1,094,4060.68%11,293159
Infectious Disease771.0%$641,7660.40%6,62686
Family Practice490.64%$442,1020.27%4,68196
Hospitalist120.16%$367,6960.23%3,347279
Radiation Oncology420.55%$231,7720.14%2,40257
Allergy/ Immunology160.21%$201,5810.13%2,001125

Not listed: 21 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 2024.

Top billers of 96413 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