HCPCS 99212

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

Evaluation and management Work RVU per service 0.70 (2024 fee schedule)

90,889
100th percentile among 6,471 codes billed · 2024
$216M
99th percentile among 6,471 codes billed · 2024
5.8M
99th percentile among 6,471 codes billed · 2024
31
59th percentile among 6,471 codes billed · 2024
212
68th percentile among 6,471 codes billed · 2024
-10.4%
Medicare payment on the code vs 2023; billers -8.2% · 2024

Trend

Medicare payment on the code

$0$200M2020: $234M paid20202021: $320M paid20212022: $279M paid20222023: $241M paid20232024: $216M paid2024$216M$0$200M2020: $234M paid20202021: $320M paid20212022: $279M paid20222023: $241M paid20232024: $216M paid2024$216M$0$200M2020: $234M paid20202021: $320M paid20212022: $279M paid20222023: $241M paid20232024: $216M paid2024$216M$0$200M2020: $234M paid20202021: $320M paid20212022: $279M paid20222023: $241M paid20232024: $216M paid2024$216M

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

Billers

050K100K2020: 111K providers20202021: 123K providers20212022: 110K providers20222023: 99K providers20232024: 91K providers202491K050K100K2020: 111K providers20202021: 123K providers20212022: 110K providers20222023: 99K providers20232024: 91K providers202491K050K100K2020: 111K providers20202021: 123K providers20212022: 110K providers20222023: 99K providers20232024: 91K providers202491K050K100K2020: 111K providers20202021: 123K providers20212022: 110K providers20222023: 99K providers20232024: 91K providers202491K

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
202490,889$216,133,383-10%5,819,455312120.70
202399,011$241,099,250-13%6,440,114312180.70
2022109,666$278,584,010-13%7,292,614322230.70
2021122,768$320,057,140+37%8,331,445322340.70
2020111,120$233,953,402first year in data7,752,244322410.48

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
California7,406$26,374,217622,60633287
New York6,809$24,777,615573,83134324
Florida6,456$17,924,862467,43435247
New Jersey3,197$11,348,594266,94036317
Texas5,203$11,201,494313,50430201
Pennsylvania4,409$9,639,562267,37531190
Illinois3,631$8,428,624229,81033202
Virginia2,660$6,067,943167,84631206
Ohio3,726$6,039,501185,39929153
Maryland2,216$5,628,685143,66532215
Massachusetts2,357$5,393,178142,35830207
Arizona2,203$5,329,719146,85833232
North Carolina2,604$5,087,828149,86432190
Georgia2,519$4,856,312140,16731174
Michigan2,437$4,628,078129,03130172

Not listed: 8 billers with an armed-forces or unknown state code (AE, AP, XX, ZZ); they are in the national totals.

Not listed: 1 state 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
New York-Newark-Jersey City, NY-NJ7,244$29,472,235660,80536
Los Angeles-Long Beach-Anaheim, CA2,387$10,033,779232,57435
Chicago-Naperville-Elgin, IL-IN2,661$6,518,341171,87133
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD2,136$6,001,060152,42934
Miami-Fort Lauderdale-West Palm Beach, FL1,577$4,779,432118,49633
Washington-Arlington-Alexandria, DC-VA-MD-WV1,619$3,981,67997,65228
Boston-Cambridge-Newton, MA-NH1,655$3,537,65290,73728
Phoenix-Mesa-Chandler, AZ1,432$3,335,17789,71332
Dallas-Fort Worth-Arlington, TX1,423$3,117,83586,09732
San Francisco-Oakland-Fremont, CA944$2,961,79564,87531
Baltimore-Columbia-Towson, MD1,120$2,702,30069,39232
Detroit-Warren-Dearborn, MI1,101$2,682,41270,57033
Atlanta-Sandy Springs-Roswell, GA1,263$2,371,54765,39029
San Jose-Sunnyvale-Santa Clara, CA488$2,170,32745,15130
Houston-Pasadena-The Woodlands, TX1,081$2,037,01755,76527

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 2024.

Specialties billing 99212 nationally

Dermatology accounts for 16% of payment for 99212 nationally in 2024, across 65 specialties on claims.

observed calculated calculated calculated calculated calculated
Dermatology8,1959.0%$35,207,95116%890,309109
Podiatry6,5807.2%$32,559,34715%810,696123
Nurse Practitioner13,01714%$20,208,2249.3%666,65551
Physician Assistant11,87613%$19,386,6799.0%607,00051
Internal Medicine6,0236.6%$14,525,1676.7%368,71761
Orthopedic Surgery5,4416.0%$12,192,2925.6%319,46759
Family Practice6,1986.8%$10,873,4455.0%293,29347
Optometry5,6116.2%$8,161,5943.8%226,97240
Ophthalmology2,9933.3%$7,948,3613.7%206,10969
General Surgery3,5363.9%$5,878,1252.7%164,87247
Otolaryngology2,4372.7%$5,481,7332.5%143,23059
Urology2,1122.3%$5,031,0082.3%126,54060
Psychiatry7650.84%$4,093,9301.9%107,945141
Cardiology1,0211.1%$2,616,6551.2%65,82964
Emergency Medicine7020.77%$2,477,4791.1%56,46780

Not listed: 12 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 99212 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