HCPCS 99203

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

Evaluation and management Work RVU per service 1.60 (2024 fee schedule)

155,883
100th percentile among 6,471 codes billed · 2024
$538M
100th percentile among 6,471 codes billed · 2024
7.7M
99th percentile among 6,471 codes billed · 2024
31
59th percentile among 6,471 codes billed · 2024
148
62nd percentile among 6,471 codes billed · 2024
-9.5%
Medicare payment on the code vs 2023; billers -3.5% · 2024

Trend

Medicare payment on the code

$0$500M2020: $600M paid20202021: $696M paid20212022: $641M paid20222023: $595M paid20232024: $538M paid2024$538M$0$500M2020: $600M paid20202021: $696M paid20212022: $641M paid20222023: $595M paid20232024: $538M paid2024$538M$0$500M2020: $600M paid20202021: $696M paid20212022: $641M paid20222023: $595M paid20232024: $538M paid2024$538M$0$500M2020: $600M paid20202021: $696M paid20212022: $641M paid20222023: $595M paid20232024: $538M paid2024$538M

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

Billers

0100K2020: 161K providers20202021: 168K providers20212022: 165K providers20222023: 162K providers20232024: 156K providers2024156K0100K2020: 161K providers20202021: 168K providers20212022: 165K providers20222023: 162K providers20232024: 156K providers2024156K0100K2020: 161K providers20202021: 168K providers20212022: 165K providers20222023: 162K providers20232024: 156K providers2024156K0100K2020: 161K providers20202021: 168K providers20212022: 165K providers20222023: 162K providers20232024: 156K providers2024156K

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
2024155,883$538,312,723-9%7,685,964311481.60
2023161,519$594,792,171-7%8,259,499311561.60
2022165,325$641,447,997-8%8,690,922321611.60
2021167,692$696,009,828+16%9,003,185321631.60
2020160,873$599,868,920first year in data8,427,867311601.42

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
California12,395$54,020,660697,62532177
New York10,984$48,904,569589,41133161
Florida11,381$46,304,621660,62835180
Texas10,208$33,401,699489,75930144
New Jersey5,638$25,489,708314,68437162
Pennsylvania7,146$23,028,859333,72630137
Illinois6,106$20,879,030293,38230148
Virginia4,739$16,651,581242,19732153
Ohio6,115$16,611,194261,64428123
Maryland3,629$16,397,865218,70038185
Massachusetts4,107$16,073,424217,35933166
Georgia5,218$15,795,322234,17829132
Arizona4,071$15,772,696239,63036182
North Carolina5,163$14,649,756228,95128133
Michigan4,296$11,940,114176,37928113

Not listed: 13 billers with an armed-forces or unknown state code (AA, AE, AP, XX, ZZ); they are in the national totals.

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-NJ11,834$58,639,334686,19836
Los Angeles-Long Beach-Anaheim, CA3,998$18,014,020224,30832
Chicago-Naperville-Elgin, IL-IN4,813$16,889,586232,96229
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD3,672$14,331,057192,87633
Washington-Arlington-Alexandria, DC-VA-MD-WV3,101$12,200,471159,46033
Boston-Cambridge-Newton, MA-NH2,996$11,914,497159,96133
Miami-Fort Lauderdale-West Palm Beach, FL2,617$10,880,545146,14632
Phoenix-Mesa-Chandler, AZ2,833$10,506,733158,01135
Dallas-Fort Worth-Arlington, TX2,748$9,060,910130,08930
Atlanta-Sandy Springs-Roswell, GA2,787$8,571,732123,23329
Baltimore-Columbia-Towson, MD1,911$8,323,329111,60036
Houston-Pasadena-The Woodlands, TX2,484$7,544,357107,66228
San Francisco-Oakland-Fremont, CA1,459$6,690,94778,80131
Detroit-Warren-Dearborn, MI2,032$6,322,58789,20431
Tampa-St. Petersburg-Clearwater, FL1,584$5,106,28275,74132

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 2024.

Specialties billing 99203 nationally

Podiatry accounts for 14% of payment for 99203 nationally in 2024, across 68 specialties on claims.

observed calculated calculated calculated calculated calculated
Podiatry11,6487.5%$74,023,26414%993,51285
Physician Assistant24,30516%$65,330,02612%1,093,68045
Orthopedic Surgery13,0808.4%$56,013,92810%757,39858
Nurse Practitioner24,28516%$54,655,30010%935,81139
Dermatology9,8066.3%$52,792,2179.8%740,00975
Otolaryngology6,4924.2%$44,147,3498.2%578,68889
Family Practice7,4764.8%$19,307,7773.6%282,40838
Gastroenterology5,4213.5%$17,832,1223.3%236,27444
General Surgery6,8104.4%$17,561,3133.3%239,97835
Urology4,0662.6%$12,063,0082.2%162,07740
Internal Medicine4,0152.6%$10,790,7322.0%148,10937
Hand Surgery1,3710.88%$10,014,5761.9%133,35997
Ophthalmology3,5722.3%$9,714,3351.8%135,02038
Vascular Surgery2,0681.3%$8,100,9931.5%101,10449
Emergency Medicine2,1851.4%$7,879,5141.5%106,91349

Not listed: 10 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 99203 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