HCPCS 99211

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

Evaluation and management Work RVU per service 0.18 (2021 fee schedule)

30,000
99th percentile among 6,253 codes billed · 2021
$59M
96th percentile among 6,253 codes billed · 2021
3.2M
98th percentile among 6,253 codes billed · 2021
36
66th percentile among 6,253 codes billed · 2021
352
77th percentile among 6,253 codes billed · 2021
+19.4%
Medicare payment on the code vs 2020; billers -6.4% · 2021

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
Florida2,701$6,871,421384,17649516
California2,498$5,976,410297,74436422
New York1,750$3,869,085188,02633308
Texas1,837$2,994,030170,66736358
Illinois1,246$2,911,709152,16033361
Arizona850$2,886,447159,46241633
New Jersey885$2,652,210127,16240551
North Carolina1,551$2,479,017146,60840283
Pennsylvania1,181$2,125,607122,43941388
Massachusetts856$2,102,801109,28140421
Minnesota1,729$2,048,846105,31327142
Virginia777$2,031,799105,47643360
Washington1,052$1,651,21089,72442272
Maryland656$1,526,26578,34335395
Georgia945$1,455,16786,16534370

Not listed: 4 billers with an armed-forces or unknown state code (AE, AP, 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,777$4,507,249213,20438
Phoenix-Mesa-Chandler, AZ594$2,475,635134,10842
Los Angeles-Long Beach-Anaheim, CA793$2,256,971107,29042
Chicago-Naperville-Elgin, IL-IN1,039$2,007,961107,26933
Washington-Arlington-Alexandria, DC-VA-MD-WV538$1,713,68785,17040
Boston-Cambridge-Newton, MA-NH602$1,689,85188,49842
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD498$1,601,29579,89644
Miami-Fort Lauderdale-West Palm Beach, FL465$1,439,92179,53045
Tampa-St. Petersburg-Clearwater, FL393$1,275,12570,50752
Dallas-Fort Worth-Arlington, TX498$988,97453,78036
Seattle-Tacoma-Bellevue, WA622$936,35449,52641
Jacksonville, FL410$852,13644,58842
Orlando-Kissimmee-Sanford, FL343$806,60646,61367
Minneapolis-St. Paul-Bloomington, MN-WI571$805,28941,32226
Rochester, MN833$800,63238,92625

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 97 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.

Specialties billing 99211 nationally

Nurse Practitioner accounts for 32% of payment for 99211 nationally in 2021, across 59 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner6,36321%$18,803,70632%1,011,279159
Family Practice5,73319%$10,404,29618%576,771101
Internal Medicine4,75416%$8,643,06415%485,114102
Cardiology1,6765.6%$3,133,8885.4%191,373114
Physician Assistant1,8976.3%$2,405,3514.1%137,00872
Emergency Medicine3361.1%$2,149,9833.7%99,221295
Urology1,4494.8%$1,417,7192.4%81,62456
Gastroenterology9473.2%$1,281,4872.2%61,60265
Hematology-Oncology6872.3%$965,3661.6%56,50982
Infectious Disease690.23%$722,2491.2%35,369513
Geriatric Medicine630.21%$559,0360.95%26,746425
Ophthalmology4341.4%$544,6770.93%29,41968
Pulmonary Disease3351.1%$496,4150.85%24,70974
Allergy/ Immunology1540.51%$382,9040.65%19,881129
Interventional Cardiology3061.0%$380,5890.65%22,97075

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 2021.

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