HCPCS 99211

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

Evaluation and management Work RVU per service 0.18 (2020 fee schedule)

32,050
99th percentile among 6,116 codes billed · 2020
$49M
96th percentile among 6,116 codes billed · 2020
2.8M
98th percentile among 6,116 codes billed · 2020
36
67th percentile among 6,116 codes billed · 2020
284
75th percentile among 6,116 codes billed · 2020

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
Florida3,070$6,256,082362,72751417
California2,473$4,704,751247,79637332
New York1,895$2,795,617143,63134243
Texas2,109$2,621,972155,41535226
Arizona1,042$2,319,703131,59743446
North Carolina1,612$2,242,038135,38741269
New Jersey938$2,079,430100,56437361
Minnesota1,649$2,011,254101,75525131
Illinois1,305$1,739,55296,95530235
Massachusetts881$1,666,40085,53439284
Pennsylvania1,215$1,661,02797,58734259
Virginia876$1,577,09586,65543286
Washington950$1,533,19085,38345298
Maryland773$1,403,68472,44338303
Georgia1,026$1,306,26777,89136253

Not listed: 5 billers with an armed-forces or unknown state code (AE, AP, XX, ZZ); 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,864$3,036,029148,45236
Phoenix-Mesa-Chandler, AZ736$1,851,432103,01843
Los Angeles-Long Beach-Anaheim, CA829$1,723,92786,60139
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD537$1,477,69972,14237
Washington-Arlington-Alexandria, DC-VA-MD-WV645$1,245,28862,55340
Chicago-Naperville-Elgin, IL-IN1,074$1,217,79269,21831
Boston-Cambridge-Newton, MA-NH620$1,161,06560,67440
Miami-Fort Lauderdale-West Palm Beach, FL511$1,032,33557,71142
Minneapolis-St. Paul-Bloomington, MN-WI525$944,75243,93421
Tampa-St. Petersburg-Clearwater, FL441$907,86852,79258
Seattle-Tacoma-Bellevue, WA528$862,69646,65742
Jacksonville, FL437$759,97040,96039
Orlando-Kissimmee-Sanford, FL391$707,78941,61457
Rochester, MN839$692,20535,37225
Dallas-Fort Worth-Arlington, TX520$643,32536,68335

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 2020.

Specialties billing 99211 nationally

Family Practice accounts for 21% of payment for 99211 nationally in 2020, across 60 specialties on claims.

observed calculated calculated calculated calculated calculated
Family Practice6,08419%$10,260,03921%578,15395
Nurse Practitioner6,13119%$9,988,77420%563,65992
Internal Medicine5,33517%$8,768,96118%514,60996
Cardiology1,9916.2%$3,884,0307.9%238,515120
Physician Assistant1,8425.7%$1,890,7603.9%114,48662
Urology1,5344.8%$1,479,6163.0%85,10155
Gastroenterology9172.9%$1,222,8192.5%57,62063
Hematology-Oncology7872.5%$1,152,0512.4%66,80985
Emergency Medicine2810.88%$1,105,8072.3%53,861192
Infectious Disease850.27%$724,6821.5%36,707432
Ophthalmology4831.5%$583,7691.2%31,21965
Geriatric Medicine730.23%$486,4890.99%23,156317
Psychiatry3301.0%$446,5050.91%36,752111
Pulmonary Disease3561.1%$445,3420.91%22,74664
Interventional Cardiology3391.1%$423,8140.86%26,31478

Not listed: 20 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 2020.

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