HCPCS 99211

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

Evaluation and management Work RVU per service 0.18 (2024 fee schedule)

13,851
98th percentile among 6,471 codes billed · 2024
$15M
90th percentile among 6,471 codes billed · 2024
962K
95th percentile among 6,471 codes billed · 2024
32
60th percentile among 6,471 codes billed · 2024
223
69th percentile among 6,471 codes billed · 2024
-21.6%
Medicare payment on the code vs 2023; billers -13.4% · 2024

Trend

Medicare payment on the code

$0$25M$50M2020: $49M paid20202021: $59M paid20212022: $45M paid20222023: $20M paid20232024: $15M paid2024$15M$0$25M$50M2020: $49M paid20202021: $59M paid20212022: $45M paid20222023: $20M paid20232024: $15M paid2024$15M$0$25M$50M2020: $49M paid20202021: $59M paid20212022: $45M paid20222023: $20M paid20232024: $15M paid2024$15M$0$25M$50M2020: $49M paid20202021: $59M paid20212022: $45M paid20222023: $20M paid20232024: $15M paid2024$15M

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

Billers

020K2020: 32K providers20202021: 30K providers20212022: 24K providers20222023: 16K providers20232024: 14K providers202414K020K2020: 32K providers20202021: 30K providers20212022: 24K providers20222023: 16K providers20232024: 14K providers202414K020K2020: 32K providers20202021: 30K providers20212022: 24K providers20222023: 16K providers20232024: 14K providers202414K020K2020: 32K providers20202021: 30K providers20212022: 24K providers20222023: 16K providers20232024: 14K providers202414K

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
202413,851$15,438,322-22%962,003322230.18
202315,987$19,688,384-56%1,191,077332400.18
202224,179$45,127,410-23%2,452,735343380.18
202130,000$58,548,097+19%3,217,936363520.18
202032,050$49,016,620first year in data2,805,317362840.18

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
California1,432$2,918,190165,84136387
Florida1,451$1,788,125112,38939274
Arizona472$735,22446,63234466
Texas783$678,52944,57433187
New York585$645,39136,55328210
Illinois546$530,33834,39128169
North Carolina640$519,81635,58934163
Maryland278$481,01322,57233330
Washington489$450,38227,73335159
Pennsylvania479$434,78428,06130170
New Jersey350$431,58623,28829256
Georgia437$422,85428,59034221
Virginia437$356,79423,48728149
Ohio431$341,13722,36029169
Oregon218$321,17616,81335284

Not listed: 3 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 2024.

Top metro areas

observed calculated calculated calculated calculated
Los Angeles-Long Beach-Anaheim, CA549$1,716,82390,46942
New York-Newark-Jersey City, NY-NJ629$830,80943,75531
Phoenix-Mesa-Chandler, AZ328$555,38634,91533
Chicago-Naperville-Elgin, IL-IN425$461,59029,62229
Miami-Fort Lauderdale-West Palm Beach, FL259$386,93723,05039
Washington-Arlington-Alexandria, DC-VA-MD-WV248$318,05316,42831
Baltimore-Columbia-Towson, MD118$276,45212,46636
Seattle-Tacoma-Bellevue, WA272$268,93215,88038
Tampa-St. Petersburg-Clearwater, FL215$250,21115,83335
Boston-Cambridge-Newton, MA-NH257$204,78012,09730
Riverside-San Bernardino-Ontario, CA141$201,75417,40735
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD183$201,50911,70933
Las Vegas-Henderson-North Las Vegas, NV73$198,84212,19746
Orlando-Kissimmee-Sanford, FL188$187,33912,39539
Dallas-Fort Worth-Arlington, TX190$173,66511,15334

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 98 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 99211 nationally

Internal Medicine accounts for 23% of payment for 99211 nationally in 2024, across 49 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine2,65819%$3,512,07723%206,15978
Family Practice2,92621%$3,353,61222%206,93571
Cardiology1,2008.7%$1,676,23911%106,23389
Nurse Practitioner1,55611%$1,217,2957.9%91,20559
Urology1,0217.4%$925,5946.0%54,81754
Hematology-Oncology5283.8%$492,1033.2%29,76656
General Practice1170.84%$374,8292.4%20,836178
Physician Assistant5674.1%$323,4742.1%23,70342
Interventional Cardiology2441.8%$254,4291.6%15,58364
Allergy/ Immunology1040.75%$240,8521.6%12,670122
Dermatology2251.6%$217,6491.4%12,13954
Psychiatry1621.2%$182,1541.2%15,04593
Ophthalmology1741.3%$180,0011.2%11,21464
Podiatry1641.2%$174,1661.1%10,28763
Endocrinology2051.5%$172,5881.1%10,50451

Not listed: 30 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 99211 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