HCPCS 99203

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

Evaluation and management Work RVU per service 1.60 (2022 fee schedule)

165,325
100th percentile among 6,326 codes billed · 2022
$641M
100th percentile among 6,326 codes billed · 2022
8.7M
99th percentile among 6,326 codes billed · 2022
32
62nd percentile among 6,326 codes billed · 2022
161
65th percentile among 6,326 codes billed · 2022
-7.8%
Medicare payment on the code vs 2021; billers -1.4% · 2022

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
California12,802$59,887,757744,94232188
New York11,556$57,754,151632,91134166
Florida11,988$56,488,360763,57237197
Texas11,002$40,755,557574,77032162
New Jersey5,647$28,695,473332,40638171
Pennsylvania7,371$26,506,899359,70131141
Illinois6,310$25,211,867336,09932165
Virginia5,014$20,289,844276,33833169
Ohio6,655$20,043,975298,31729129
Maryland3,742$19,397,391241,45639199
Georgia5,480$19,259,308271,17432144
North Carolina5,684$18,943,872279,26330152
Massachusetts4,292$18,683,229240,48336176
Arizona4,102$17,694,355259,74137200
Michigan4,693$15,905,763217,23030126

Not listed: 19 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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ12,202$68,097,710725,69737
Los Angeles-Long Beach-Anaheim, CA4,305$20,533,434244,50431
Chicago-Naperville-Elgin, IL-IN4,840$19,967,986261,25932
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD3,750$16,480,958207,40033
Washington-Arlington-Alexandria, DC-VA-MD-WV3,227$15,023,203183,09434
Boston-Cambridge-Newton, MA-NH3,049$13,494,096171,19236
Miami-Fort Lauderdale-West Palm Beach, FL2,808$13,267,885165,93834
Phoenix-Mesa-Chandler, AZ2,854$11,810,515171,40436
Dallas-Fort Worth-Arlington, TX2,771$10,501,901145,17833
Atlanta-Sandy Springs-Roswell, GA2,862$10,102,044137,30730
Baltimore-Columbia-Towson, MD1,981$9,532,628119,89838
Houston-Pasadena-The Woodlands, TX2,629$9,459,645128,25230
Detroit-Warren-Dearborn, MI2,234$8,693,468111,42532
San Francisco-Oakland-Fremont, CA1,468$7,138,71582,89733
Tampa-St. Petersburg-Clearwater, FL1,638$6,355,01088,50034

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 2022.

Specialties billing 99203 nationally

Podiatry accounts for 13% of payment for 99203 nationally in 2022, across 68 specialties on claims.

observed calculated calculated calculated calculated calculated
Podiatry11,8867.2%$83,298,19413%1,082,86791
Orthopedic Surgery14,2438.6%$71,535,21311%939,85266
Physician Assistant22,51814%$70,261,26211%1,080,90948
Nurse Practitioner23,59414%$60,746,6899.5%941,30540
Dermatology9,8416.0%$60,340,2299.4%828,89584
Otolaryngology6,7634.1%$51,834,4678.1%667,42899
Family Practice9,9736.0%$30,411,2424.7%397,86640
Gastroenterology6,2923.8%$23,043,8723.6%300,19048
General Surgery7,5294.6%$21,300,6383.3%282,49138
Urology4,6702.8%$15,988,0992.5%211,08445
Internal Medicine5,4353.3%$15,167,0212.4%193,57836
Emergency Medicine2,4761.5%$13,596,0012.1%154,38462
Ophthalmology3,6732.2%$10,764,4411.7%147,71940
Hand Surgery1,3490.82%$10,566,2851.6%137,466102
Vascular Surgery2,0791.3%$8,837,0241.4%107,55252

Not listed: 9 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 2022.

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