HCPCS 99213

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

Evaluation and management Work RVU per service 1.30 (2023 fee schedule)

457,151
100th percentile among 6,405 codes billed · 2023
$4.12B
100th percentile among 6,405 codes billed · 2023
70.2M
100th percentile among 6,405 codes billed · 2023
75
82nd percentile among 6,405 codes billed · 2023
550
81st percentile among 6,405 codes billed · 2023
-4.5%
Medicare payment on the code vs 2022; billers +0.3% · 2023

Trend

Medicare payment on the code

$0$2.00B$4.00B2020: $3.64B paid20202021: $4.58B paid20212022: $4.32B paid20222023: $4.12B paid20232024: $3.97B paid2024$3.97B$0$2.00B$4.00B2020: $3.64B paid20202021: $4.58B paid20212022: $4.32B paid20222023: $4.12B paid20232024: $3.97B paid2024$3.97B$0$2.00B$4.00B2020: $3.64B paid20202021: $4.58B paid20212022: $4.32B paid20222023: $4.12B paid20232024: $3.97B paid2024$3.97B$0$2.00B$4.00B2020: $3.64B paid20202021: $4.58B paid20212022: $4.32B paid20222023: $4.12B paid20232024: $3.97B paid2024$3.97B

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

Billers

0200K400K2020: 443K providers20202021: 455K providers20212022: 456K providers20222023: 457K providers20232024: 458K providers2024458K0200K400K2020: 443K providers20202021: 455K providers20212022: 456K providers20222023: 457K providers20232024: 458K providers2024458K0200K400K2020: 443K providers20202021: 455K providers20212022: 456K providers20222023: 457K providers20232024: 458K providers2024458K0200K400K2020: 443K providers20202021: 455K providers20212022: 456K providers20222023: 457K providers20232024: 458K providers2024458K

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
2024457,569$3,967,726,634-4%67,927,936725331.30
2023457,151$4,123,102,926-4%70,165,439755501.30
2022455,642$4,316,975,149-6%72,368,685775701.30
2021455,329$4,578,684,345+26%74,572,954805901.30
2020442,931$3,641,690,420first year in data74,817,627826060.97

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
California34,657$457,883,8316,925,90783752
New York31,435$379,879,8285,484,88080643
Florida30,012$361,567,1925,943,88684763
Texas29,786$250,533,2114,370,27472525
New Jersey14,085$184,116,4752,747,60999705
Pennsylvania22,374$171,393,6372,986,99468466
Illinois17,386$152,343,5872,557,15574516
Ohio19,999$131,317,8522,524,89472417
Virginia12,439$124,415,0862,128,50190581
Georgia13,356$122,377,5982,162,88884567
Massachusetts13,700$120,554,3671,991,18873511
Maryland9,276$116,099,3081,880,96899731
North Carolina16,319$115,972,8862,128,30168445
Michigan14,806$97,735,0231,750,94062416
Arizona9,602$92,449,6501,623,25378614

Not listed: 58 billers with an armed-forces or unknown state code (AA, 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ30,128$440,631,1276,128,95495
Los Angeles-Long Beach-Anaheim, CA12,149$174,094,5912,551,34081
Chicago-Naperville-Elgin, IL-IN13,263$119,938,3981,959,98072
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD10,395$100,939,1291,643,25379
Washington-Arlington-Alexandria, DC-VA-MD-WV7,973$90,499,0841,389,26280
Miami-Fort Lauderdale-West Palm Beach, FL7,516$88,841,7531,377,44272
Boston-Cambridge-Newton, MA-NH9,938$84,806,3381,381,07669
Dallas-Fort Worth-Arlington, TX8,201$66,129,4161,133,74369
Phoenix-Mesa-Chandler, AZ6,642$59,995,5951,038,96072
Atlanta-Sandy Springs-Roswell, GA7,081$58,071,187995,01473
Detroit-Warren-Dearborn, MI6,508$54,099,277914,04170
Houston-Pasadena-The Woodlands, TX7,271$53,946,815903,54860
Baltimore-Columbia-Towson, MD4,899$53,866,002890,78390
San Francisco-Oakland-Fremont, CA4,060$48,799,433685,54774
Tampa-St. Petersburg-Clearwater, FL4,622$41,876,332704,17070

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 2023.

Specialties billing 99213 nationally

Family Practice accounts for 11% of payment for 99213 nationally in 2023, across 72 specialties on claims.

observed calculated calculated calculated calculated calculated
Family Practice57,45013%$456,865,17211%8,058,351140
Nurse Practitioner87,43819%$453,296,47411%9,279,505106
Internal Medicine42,5729.3%$444,841,08011%7,402,650174
Dermatology11,6082.5%$363,884,5568.8%5,885,970507
Physician Assistant53,89512%$353,638,2348.6%6,958,819129
Podiatry13,1942.9%$295,607,4197.2%4,470,864339
Orthopedic Surgery18,8174.1%$239,091,5345.8%3,728,074198
Ophthalmology10,7892.4%$166,596,4434.0%2,677,207248
Urology8,0791.8%$135,123,2673.3%2,153,380267
Otolaryngology7,8231.7%$110,209,3842.7%1,705,824218
Cardiology10,4042.3%$108,927,9272.6%1,739,603167
Optometry18,1814.0%$103,954,2822.5%1,772,20897
Hematology-Oncology5,8291.3%$73,149,7471.8%1,206,127207
Psychiatry6,1181.3%$67,176,3011.6%1,108,991181
Gastroenterology9,0982.0%$58,842,7191.4%910,844100

Not listed: 10 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 99213 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