HCPCS 99202

Evaluation and management service (ClaimLight category; the code descriptor is not shown)

Evaluation and management Work RVU per service 0.93 (2021 fee schedule)

35,204
99th percentile among 6,253 codes billed · 2021
$66M
97th percentile among 6,253 codes billed · 2021
1.3M
96th percentile among 6,253 codes billed · 2021
23
48th percentile among 6,253 codes billed · 2021
105
57th percentile among 6,253 codes billed · 2021
-24.2%
Medicare payment on the code vs 2020; billers -16.8% · 2021

Trend

Medicare payment on the code

$0$50M2020: $87M paid20202021: $66M paid20212022: $46M paid20222023: $31M paid20232024: $24M paid2024$24M$0$50M2020: $87M paid20202021: $66M paid20212022: $46M paid20222023: $31M paid20232024: $24M paid2024$24M$0$50M2020: $87M paid20202021: $66M paid20212022: $46M paid20222023: $31M paid20232024: $24M paid2024$24M$0$50M2020: $87M paid20202021: $66M paid20212022: $46M paid20222023: $31M paid20232024: $24M paid2024$24M

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

Billers

020K40K2020: 42K providers20202021: 35K providers20212022: 27K providers20222023: 21K providers20232024: 17K providers202417K020K40K2020: 42K providers20202021: 35K providers20212022: 27K providers20222023: 21K providers20232024: 17K providers202417K020K40K2020: 42K providers20202021: 35K providers20212022: 27K providers20222023: 21K providers20232024: 17K providers202417K020K40K2020: 42K providers20202021: 35K providers20212022: 27K providers20222023: 21K providers20232024: 17K providers202417K

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
202417,327$24,468,864-21%554,11621890.93
202320,840$30,799,693-33%687,59221940.93
202227,411$46,059,884-30%948,98421990.93
202135,204$66,017,462-24%1,281,570231050.93
202042,337$87,124,681first year in data1,742,099251210.93

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
New York2,734$7,644,694117,42223123
California2,465$5,309,83293,43623108
Florida2,602$5,023,22796,57622104
Texas1,975$3,635,86773,66723112
New Jersey1,282$3,500,01656,40927119
Pennsylvania1,705$2,976,32359,3542496
Illinois1,430$2,659,93451,7962399
Maryland1,084$2,385,97642,66126104
Virginia1,241$2,347,21545,50123104
Ohio1,511$2,149,54347,8642286
North Carolina1,272$2,103,80144,8432291
Georgia1,136$1,827,26037,0792290
Michigan950$1,815,13735,73523117
Massachusetts934$1,778,34633,64522113
Connecticut675$1,508,17225,39224101

Not listed: 5 billers with an armed-forces or unknown state code (AE, AP, XX); they are in the national totals.

Not listed: 2 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ2,835$8,942,489133,19825
Chicago-Naperville-Elgin, IL-IN1,048$1,958,59936,34322
Los Angeles-Long Beach-Anaheim, CA794$1,904,41131,58823
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD892$1,849,16933,36525
Washington-Arlington-Alexandria, DC-VA-MD-WV821$1,617,10627,78822
Miami-Fort Lauderdale-West Palm Beach, FL631$1,532,89727,00923
Baltimore-Columbia-Towson, MD561$1,249,17622,51027
Boston-Cambridge-Newton, MA-NH597$1,090,33220,42522
Dallas-Fort Worth-Arlington, TX512$984,38819,26524
Atlanta-Sandy Springs-Roswell, GA629$967,88418,24121
Detroit-Warren-Dearborn, MI443$944,73416,96722
Phoenix-Mesa-Chandler, AZ585$906,63218,64721
Houston-Pasadena-The Woodlands, TX417$787,43414,79922
St. Louis, MO-IL410$739,24914,75725
San Francisco-Oakland-Fremont, CA324$717,05611,82724

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 100 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.

Specialties billing 99202 nationally

Nurse Practitioner accounts for 16% of payment for 99202 nationally in 2021, across 56 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner6,94820%$10,801,28516%211,87830
Physician Assistant5,52916%$9,255,45014%185,48534
Dermatology4,76314%$9,103,68214%192,89140
Podiatry3,2099.1%$7,919,72312%158,98350
Family Practice2,2056.3%$5,267,3018.0%87,61440
Internal Medicine8512.4%$2,793,3644.2%45,66654
Emergency Medicine7932.3%$2,570,8013.9%38,28548
Otolaryngology1,3974.0%$2,536,2683.8%51,38737
General Surgery1,6154.6%$2,320,1583.5%47,50229
Orthopedic Surgery1,1503.3%$1,876,6842.8%38,48433
Gastroenterology1,1023.1%$1,836,3912.8%37,20534
Plastic and Reconstructive Surgery5391.5%$1,052,7711.6%20,58138
Physical Medicine and Rehabilitation2150.61%$652,1130.99%12,07756
Vascular Surgery3490.99%$611,4980.93%11,55633
Urology3841.1%$553,6250.84%11,45030

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 2021.

Top billers of 99202 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