HCPCS 99211

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

Evaluation and management Work RVU per service 0.18 (2023 fee schedule)

15,987
98th percentile among 6,405 codes billed · 2023
$20M
92nd percentile among 6,405 codes billed · 2023
1.2M
96th percentile among 6,405 codes billed · 2023
33
62nd percentile among 6,405 codes billed · 2023
240
70th percentile among 6,405 codes billed · 2023
-56.4%
Medicare payment on the code vs 2022; billers -33.9% · 2023

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
California1,613$3,899,422207,47936428
Florida1,698$2,583,820157,61448305
New York852$1,052,85054,87629207
Texas970$881,11656,96133195
Arizona522$796,88051,05335454
Illinois641$635,30539,39630185
North Carolina723$632,69042,44834177
New Jersey442$603,90030,93332273
Pennsylvania573$603,24838,51233214
Georgia481$536,30435,50940241
Virginia478$515,24631,20332232
Washington546$512,70033,16135194
Ohio464$437,98028,17733184
Maryland350$432,11323,90230263
Massachusetts364$392,43023,31136240

Not listed: 1 billers with an armed-forces or unknown state code (AP); they are in the national totals.

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 2023.

Top metro areas

observed calculated calculated calculated calculated
Los Angeles-Long Beach-Anaheim, CA614$2,290,064111,55542
New York-Newark-Jersey City, NY-NJ875$1,264,79463,00934
Phoenix-Mesa-Chandler, AZ354$615,09138,98036
Chicago-Naperville-Elgin, IL-IN515$562,13033,84229
Miami-Fort Lauderdale-West Palm Beach, FL280$496,44329,02046
Tampa-St. Petersburg-Clearwater, FL280$424,48425,36747
Washington-Arlington-Alexandria, DC-VA-MD-WV302$414,99722,85336
Orlando-Kissimmee-Sanford, FL230$343,83621,61559
Seattle-Tacoma-Bellevue, WA319$322,74420,38538
Boston-Cambridge-Newton, MA-NH298$308,55117,97236
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD240$300,07016,66635
San Francisco-Oakland-Fremont, CA113$265,90712,21030
Riverside-San Bernardino-Ontario, CA154$232,35119,95431
Atlanta-Sandy Springs-Roswell, GA230$231,31514,23833
Dallas-Fort Worth-Arlington, TX248$223,93414,13428

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 2023.

Specialties billing 99211 nationally

Internal Medicine accounts for 22% of payment for 99211 nationally in 2023, across 51 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine3,00519%$4,324,82422%252,27184
Family Practice3,30721%$4,015,59120%236,29271
Nurse Practitioner1,93412%$2,295,33012%146,46076
Cardiology1,3368.4%$2,030,22610%129,63097
Urology1,1387.1%$1,038,1295.3%61,03154
Hematology-Oncology6013.8%$722,2563.7%43,05572
Physician Assistant6734.2%$435,1972.2%30,47845
Interventional Cardiology2431.5%$293,0611.5%18,14075
Allergy/ Immunology1130.71%$251,6841.3%13,131116
Emergency Medicine1160.73%$248,9461.3%12,175105
Ophthalmology2311.4%$227,1011.2%13,75760
Psychiatry2051.3%$219,2991.1%18,32189
Dermatology2341.5%$214,5461.1%12,11952
General Practice1130.71%$202,6621.0%12,070107
Medical Oncology1340.84%$191,6520.97%11,75888

Not listed: 25 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 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