HCPCS 99203

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

Evaluation and management Work RVU per service 1.60 (2023 fee schedule)

161,519
100th percentile among 6,405 codes billed · 2023
$595M
100th percentile among 6,405 codes billed · 2023
8.3M
99th percentile among 6,405 codes billed · 2023
31
60th percentile among 6,405 codes billed · 2023
156
63rd percentile among 6,405 codes billed · 2023
-7.3%
Medicare payment on the code vs 2022; billers -2.3% · 2023

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
California12,743$58,187,649735,27532186
New York11,356$53,041,927612,80033164
Florida11,721$52,129,564723,94036191
Texas10,820$37,223,323535,19330152
New Jersey5,662$27,305,295328,00039166
Pennsylvania7,328$25,331,928352,92130141
Illinois6,153$23,283,172317,38932161
Virginia4,922$18,716,942262,82633163
Ohio6,376$18,231,293278,28529124
Maryland3,632$18,072,866232,88939201
Georgia5,349$17,636,184255,42731137
Massachusetts4,293$17,594,922230,64534170
North Carolina5,448$16,664,111251,91529144
Arizona4,099$16,599,904248,77736191
Michigan4,560$13,736,661196,68029117

Not listed: 22 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ12,117$62,959,549706,61537
Los Angeles-Long Beach-Anaheim, CA4,189$19,839,868240,73731
Chicago-Naperville-Elgin, IL-IN4,785$18,525,773248,33632
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD3,712$15,551,178201,70633
Washington-Arlington-Alexandria, DC-VA-MD-WV3,158$13,704,505172,93933
Boston-Cambridge-Newton, MA-NH3,114$13,024,604168,62534
Miami-Fort Lauderdale-West Palm Beach, FL2,747$12,164,917158,26333
Phoenix-Mesa-Chandler, AZ2,881$11,156,270165,54835
Dallas-Fort Worth-Arlington, TX2,839$9,971,757140,17031
Atlanta-Sandy Springs-Roswell, GA2,819$9,302,002130,69629
Baltimore-Columbia-Towson, MD1,938$9,208,009119,16339
Houston-Pasadena-The Woodlands, TX2,658$8,481,440118,52328
Detroit-Warren-Dearborn, MI2,103$7,129,66197,15931
San Francisco-Oakland-Fremont, CA1,448$6,917,41981,06033
Tampa-St. Petersburg-Clearwater, FL1,601$5,827,55284,07334

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 2023.

Specialties billing 99203 nationally

Podiatry accounts for 14% of payment for 99203 nationally in 2023, across 68 specialties on claims.

observed calculated calculated calculated calculated calculated
Podiatry11,8197.3%$81,372,78114%1,061,40990
Physician Assistant23,65915%$68,039,82711%1,104,06547
Orthopedic Surgery13,6878.5%$63,988,71311%844,07462
Dermatology9,8446.1%$58,860,7819.9%808,24682
Nurse Practitioner24,47415%$57,967,1229.7%958,01239
Otolaryngology6,6254.1%$48,376,8888.1%622,44194
Family Practice8,5055.3%$23,788,9934.0%333,53039
Gastroenterology6,0143.7%$20,822,3283.5%272,27745
General Surgery7,0824.4%$19,262,1333.2%258,43736
Urology4,4362.7%$14,335,5952.4%189,61843
Internal Medicine4,6292.9%$11,744,8562.0%159,06434
Ophthalmology3,7212.3%$10,574,9581.8%144,77639
Hand Surgery1,3670.85%$10,504,5691.8%136,765100
Emergency Medicine2,3541.5%$9,570,8071.6%123,27352
Vascular Surgery2,0361.3%$8,511,8231.4%104,54351

Not listed: 6 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 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