HCPCS 99211

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

Evaluation and management Work RVU per service 0.18 (2022 fee schedule)

24,179
99th percentile among 6,326 codes billed · 2022
$45M
96th percentile among 6,326 codes billed · 2022
2.5M
98th percentile among 6,326 codes billed · 2022
34
64th percentile among 6,326 codes billed · 2022
338
76th percentile among 6,326 codes billed · 2022
-22.9%
Medicare payment on the code vs 2021; billers -19.4% · 2022

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
California2,341$6,766,043330,16336495
Florida2,267$5,762,537319,70848508
New York1,547$3,872,635181,07935317
Texas1,398$2,188,119126,44236328
Arizona879$2,008,683114,14837495
Massachusetts608$1,694,57383,02532416
New Jersey609$1,678,97277,85433534
Illinois982$1,665,54090,35730285
North Carolina1,112$1,492,74990,35036250
Pennsylvania937$1,469,36986,00732319
Virginia642$1,292,11769,29535302
Georgia692$1,223,41471,08034404
Minnesota1,203$1,102,15760,25424128
Washington936$1,086,46261,53736225
Ohio648$985,65156,81731317

Not listed: 1 billers with an armed-forces or unknown state code (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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,388$4,069,870183,21136
Los Angeles-Long Beach-Anaheim, CA892$3,110,208142,30739
Phoenix-Mesa-Chandler, AZ649$1,678,37893,11739
Boston-Cambridge-Newton, MA-NH480$1,479,29771,87033
Miami-Fort Lauderdale-West Palm Beach, FL408$1,361,76973,98744
Chicago-Naperville-Elgin, IL-IN802$1,166,74164,35632
Washington-Arlington-Alexandria, DC-VA-MD-WV427$1,124,67457,35739
Tampa-St. Petersburg-Clearwater, FL319$935,92951,75254
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD381$777,29039,43031
San Diego-Chula Vista-Carlsbad, CA107$744,69033,35356
Orlando-Kissimmee-Sanford, FL315$737,50542,09267
Jacksonville, FL314$733,22938,13832
Atlanta-Sandy Springs-Roswell, GA352$728,75938,78433
Dallas-Fort Worth-Arlington, TX385$675,94937,50636
Seattle-Tacoma-Bellevue, WA574$622,29935,00032

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 2022.

Specialties billing 99211 nationally

Nurse Practitioner accounts for 32% of payment for 99211 nationally in 2022, across 58 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner4,29118%$14,312,03532%754,047176
Family Practice4,72520%$7,294,06016%402,31985
Internal Medicine4,04017%$7,293,62716%397,05798
Cardiology1,5406.4%$2,583,3075.7%159,734104
Emergency Medicine2691.1%$1,889,7034.2%80,826300
Physician Assistant1,5836.5%$1,747,3723.9%98,45062
Urology1,3105.4%$1,220,1342.7%69,65353
Hematology-Oncology6462.7%$866,4751.9%50,44478
Gastroenterology5872.4%$726,6461.6%34,89459
General Practice1760.73%$421,4250.93%22,995131
Ophthalmology3401.4%$387,9150.86%21,27363
Pulmonary Disease2791.2%$384,3290.85%18,79367
Interventional Cardiology3001.2%$382,9350.85%23,05777
Allergy/ Immunology1200.50%$313,4590.69%15,977133
Psychiatry2330.96%$313,1770.69%25,267108

Not listed: 21 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 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