HCPCS 96413
Other service (ClaimLight category; the code descriptor is not shown)
Other services Work RVU per service 0.28 (2023 fee schedule)
Trend
Medicare payment on the code
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.
Billers
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 | |
|---|---|---|---|---|---|---|---|
| 2024 | 7,637 | $160,936,500 | +0% | 1,637,325 | 148 | 620 | 0.28 |
| 2023 | 7,514 | $160,478,106 | -4% | 1,591,566 | 146 | 625 | 0.28 |
| 2022 | 7,300 | $166,447,793 | -11% | 1,550,193 | 147 | 619 | 0.28 |
| 2021 | 7,210 | $187,397,792 | -4% | 1,622,360 | 159 | 659 | 0.28 |
| 2020 | 7,264 | $195,032,293 | first year in data | 1,768,325 | 172 | 713 | 0.28 |
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 | |
|---|---|---|---|---|---|---|
| Florida | 733 | $19,111,739 | 193,474 | 198 | 759 | |
| California | 619 | $16,667,655 | 139,332 | 170 | 603 | |
| Texas | 814 | $16,041,642 | 163,600 | 150 | 545 | |
| Illinois | 367 | $7,093,744 | 69,943 | 125 | 581 | |
| New York | 383 | $6,933,359 | 61,548 | 114 | 447 | |
| Maryland | 234 | $6,931,365 | 61,479 | 203 | 763 | |
| Virginia | 229 | $6,517,536 | 63,510 | 245 | 643 | |
| New Jersey | 225 | $5,989,414 | 52,091 | 186 | 728 | |
| Pennsylvania | 299 | $5,918,557 | 57,215 | 137 | 505 | |
| Arizona | 227 | $5,624,008 | 57,327 | 187 | 734 | |
| Tennessee | 244 | $4,609,688 | 51,531 | 146 | 580 | |
| North Carolina | 275 | $4,340,359 | 45,995 | 93 | 552 | |
| Ohio | 212 | $3,553,407 | 38,260 | 130 | 499 | |
| South Carolina | 148 | $3,271,245 | 35,743 | 144 | 634 | |
| Georgia | 155 | $3,150,956 | 33,652 | 167 | 647 |
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 2023.
Top metro areas
| observed | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|
| New York-Newark-Jersey City, NY-NJ | 336 | $8,037,953 | 66,990 | 146 | |
| Los Angeles-Long Beach-Anaheim, CA | 289 | $6,842,417 | 57,321 | 143 | |
| Chicago-Naperville-Elgin, IL-IN | 274 | $5,322,319 | 51,567 | 130 | |
| Philadelphia-Camden-Wilmington, PA-NJ-DE-MD | 205 | $5,037,638 | 46,170 | 181 | |
| Washington-Arlington-Alexandria, DC-VA-MD-WV | 189 | $4,910,137 | 42,936 | 188 | |
| Dallas-Fort Worth-Arlington, TX | 286 | $4,701,641 | 47,948 | 143 | |
| Phoenix-Mesa-Chandler, AZ | 164 | $3,968,912 | 40,620 | 182 | |
| Baltimore-Columbia-Towson, MD | 118 | $3,404,476 | 30,765 | 188 | |
| Tampa-St. Petersburg-Clearwater, FL | 132 | $3,065,631 | 31,736 | 161 | |
| Miami-Fort Lauderdale-West Palm Beach, FL | 151 | $2,996,315 | 28,840 | 139 | |
| Houston-Pasadena-The Woodlands, TX | 168 | $2,886,260 | 28,657 | 122 | |
| San Antonio-New Braunfels, TX | 105 | $2,192,483 | 22,608 | 150 | |
| San Francisco-Oakland-Fremont, CA | 70 | $2,157,962 | 15,864 | 199 | |
| St. Louis, MO-IL | 110 | $2,137,927 | 21,909 | 147 | |
| Virginia Beach-Chesapeake-Norfolk, VA-NC | 65 | $1,869,710 | 18,627 | 251 |
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 93 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 96413 nationally
Hematology-Oncology accounts for 49% of payment for 96413 nationally in 2023, across 18 specialties on claims.
| observed | calculated | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|---|
| Hematology-Oncology | 2,623 | 35% | $78,099,619 | 49% | 764,358 | 291 |
| Rheumatology | 1,549 | 21% | $38,118,980 | 24% | 379,149 | 245 |
| Medical Oncology | 895 | 12% | $23,924,881 | 15% | 236,328 | 264 |
| Internal Medicine | 336 | 4.5% | $5,727,308 | 3.6% | 56,688 | 169 |
| Nurse Practitioner | 783 | 10% | $4,754,389 | 3.0% | 56,296 | 72 |
| Hematology | 77 | 1.0% | $2,025,674 | 1.3% | 18,687 | 243 |
| Gastroenterology | 508 | 6.8% | $1,776,361 | 1.1% | 18,125 | 36 |
| Neurology | 174 | 2.3% | $1,160,982 | 0.72% | 11,862 | 68 |
| Gynecological Oncology | 80 | 1.1% | $1,137,260 | 0.71% | 11,476 | 143 |
| Physician Assistant | 152 | 2.0% | $985,015 | 0.61% | 11,282 | 74 |
| Infectious Disease | 75 | 1.00% | $575,525 | 0.36% | 5,816 | 78 |
| Family Practice | 66 | 0.88% | $422,916 | 0.26% | 4,284 | 65 |
| Radiation Oncology | 52 | 0.69% | $332,135 | 0.21% | 3,403 | 65 |
| Hospitalist | 13 | 0.17% | $251,200 | 0.16% | 2,187 | 168 |
| Hematopoietic Cell Transplantation and Cellular Therapy | 12 | 0.16% | $207,299 | 0.13% | 2,148 | 179 |
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 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