HCPCS 99214

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

Evaluation and management Work RVU per service 1.92 (2021 fee schedule)

449,158
100th percentile among 6,253 codes billed · 2021
$8.41B
100th percentile among 6,253 codes billed · 2021
96.3M
100th percentile among 6,253 codes billed · 2021
109
87th percentile among 6,253 codes billed · 2021
763
85th percentile among 6,253 codes billed · 2021
+35.2%
Medicare payment on the code vs 2020; billers +5.0% · 2021

Trend

Medicare payment on the code

$0$5.00B2020: $6.22B paid20202021: $8.41B paid20212022: $8.14B paid20222023: $8.23B paid20232024: $8.43B paid2024$8.43B$0$5.00B2020: $6.22B paid20202021: $8.41B paid20212022: $8.14B paid20222023: $8.23B paid20232024: $8.43B paid2024$8.43B$0$5.00B2020: $6.22B paid20202021: $8.41B paid20212022: $8.14B paid20222023: $8.23B paid20232024: $8.43B paid2024$8.43B$0$5.00B2020: $6.22B paid20202021: $8.41B paid20212022: $8.14B paid20222023: $8.23B paid20232024: $8.43B paid2024$8.43B

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

Billers

0200K400K2020: 428K providers20202021: 449K providers20212022: 463K providers20222023: 480K providers20232024: 498K providers2024498K0200K400K2020: 428K providers20202021: 449K providers20212022: 463K providers20222023: 480K providers20232024: 498K providers2024498K0200K400K2020: 428K providers20202021: 449K providers20212022: 463K providers20222023: 480K providers20232024: 498K providers2024498K0200K400K2020: 428K providers20202021: 449K providers20212022: 463K providers20222023: 480K providers20232024: 498K providers2024498K

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
2024498,045$8,429,417,260+2%102,377,8571077211.92
2023479,517$8,232,146,357+1%99,338,8041077311.92
2022463,447$8,139,871,713-3%97,229,1041077431.92
2021449,158$8,409,089,386+35%96,343,0711097631.92
2020427,811$6,217,850,436first year in data87,626,3871027371.50

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
California34,629$837,941,1568,545,035116915
Florida29,859$816,682,0168,902,1951391,114
Texas29,178$575,006,4526,620,775116795
New York28,969$566,300,7455,590,90495703
Pennsylvania22,150$347,222,0594,025,455101611
Illinois17,879$331,843,8433,729,438112725
New Jersey12,550$313,715,9133,146,747135863
North Carolina17,048$304,608,3413,708,562121726
Virginia12,067$275,259,5093,175,167142906
Maryland9,654$260,422,4922,755,1421441,013
Georgia12,721$253,506,1892,982,623124821
Massachusetts14,477$245,012,0042,706,507104636
Ohio18,730$243,276,0243,155,27797560
Arizona9,689$213,406,5852,445,645118927
Michigan14,884$196,700,8942,389,60687548

Not listed: 54 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ26,902$648,074,0786,071,009111
Los Angeles-Long Beach-Anaheim, CA12,100$285,335,1462,835,411110
Chicago-Naperville-Elgin, IL-IN13,804$258,641,5702,832,362109
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD10,578$202,821,2052,223,322114
Washington-Arlington-Alexandria, DC-VA-MD-WV7,800$196,840,3091,994,427128
Miami-Fort Lauderdale-West Palm Beach, FL7,517$173,972,2221,805,122108
Boston-Cambridge-Newton, MA-NH10,760$169,101,0971,845,84597
Dallas-Fort Worth-Arlington, TX8,278$153,192,4351,737,749114
Phoenix-Mesa-Chandler, AZ6,637$143,182,7331,625,345111
Houston-Pasadena-The Woodlands, TX7,085$122,237,4791,351,62898
Baltimore-Columbia-Towson, MD5,348$121,660,9901,321,721125
Atlanta-Sandy Springs-Roswell, GA6,856$117,286,3191,340,007110
Tampa-St. Petersburg-Clearwater, FL4,831$106,228,4741,180,431127
Detroit-Warren-Dearborn, MI6,485$106,065,7551,203,82998
San Francisco-Oakland-Fremont, CA4,356$90,985,529877,079108

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 2021.

Specialties billing 99214 nationally

Internal Medicine accounts for 17% of payment for 99214 nationally in 2021, across 73 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine49,59311%$1,398,238,96417%16,008,606323
Family Practice61,29614%$1,322,673,64816%16,000,989261
Nurse Practitioner76,67317%$770,882,4119.2%10,544,881138
Cardiology16,9363.8%$765,059,0009.1%8,182,443483
Physician Assistant41,2099.2%$362,623,0884.3%4,831,076117
Hematology-Oncology7,7541.7%$291,071,2923.5%3,184,321411
Ophthalmology10,4032.3%$269,162,8803.2%2,923,009281
Urology8,0561.8%$249,746,6703.0%2,655,101330
Orthopedic Surgery16,5923.7%$235,277,7222.8%2,451,722148
Neurology10,7542.4%$197,622,0912.4%2,134,758199
Endocrinology5,5461.2%$193,409,3462.3%2,082,145375
Pulmonary Disease7,7801.7%$187,497,3152.2%1,954,825251
Dermatology9,4212.1%$175,080,9712.1%1,902,787202
Rheumatology4,5821.0%$173,735,1112.1%1,876,821410
Nephrology7,5181.7%$167,195,0252.0%1,785,185237

Not listed: 9 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 99214 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