HCPCS 99214

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

Evaluation and management Work RVU per service 1.92 (2023 fee schedule)

479,517
100th percentile among 6,405 codes billed · 2023
$8.23B
100th percentile among 6,405 codes billed · 2023
99.3M
100th percentile among 6,405 codes billed · 2023
107
86th percentile among 6,405 codes billed · 2023
731
83rd percentile among 6,405 codes billed · 2023
+1.1%
Medicare payment on the code vs 2022; billers +3.5% · 2023

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
California37,972$880,443,5089,398,269115915
Florida32,757$819,161,8249,428,3261351,071
New York30,447$577,454,0055,961,66494720
Texas32,500$571,693,3576,940,022111747
Pennsylvania23,232$337,730,8064,181,961103606
New Jersey13,636$321,598,9273,424,816134864
Illinois18,537$316,885,4813,739,470112681
North Carolina18,057$273,045,2353,517,799114649
Virginia12,885$270,170,2113,267,513138878
Maryland10,274$247,489,8302,904,5371481,026
Georgia13,643$242,717,5602,976,473118760
Massachusetts15,413$240,864,4522,843,575107609
Ohio20,010$234,123,7863,234,94696528
Arizona10,407$214,266,0552,578,881121913
Tennessee11,371$188,256,1542,485,857121721

Not listed: 69 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-NJ28,723$673,297,0316,667,663112
Los Angeles-Long Beach-Anaheim, CA13,383$304,483,5623,173,899108
Chicago-Naperville-Elgin, IL-IN14,501$254,124,6482,926,250112
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD11,365$204,826,7112,420,134116
Washington-Arlington-Alexandria, DC-VA-MD-WV8,402$192,444,2052,098,281129
Miami-Fort Lauderdale-West Palm Beach, FL8,215$178,481,1901,951,784106
Boston-Cambridge-Newton, MA-NH11,486$168,464,9711,974,798100
Dallas-Fort Worth-Arlington, TX9,351$155,920,1251,873,994110
Phoenix-Mesa-Chandler, AZ7,227$147,066,4511,753,596114
Houston-Pasadena-The Woodlands, TX8,055$127,595,4311,483,52796
Baltimore-Columbia-Towson, MD5,715$118,454,7331,427,003132
Atlanta-Sandy Springs-Roswell, GA7,389$114,713,6501,367,925107
Tampa-St. Petersburg-Clearwater, FL5,279$104,266,9231,225,048123
Detroit-Warren-Dearborn, MI6,804$97,838,8381,192,04196
San Francisco-Oakland-Fremont, CA4,558$94,264,135938,959109

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 99214 nationally

Internal Medicine accounts for 15% of payment for 99214 nationally in 2023, across 73 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine48,52910%$1,245,200,83715%15,042,770310
Family Practice61,01413%$1,205,887,64615%15,345,042252
Nurse Practitioner93,24719%$905,059,08511%12,995,052139
Cardiology16,8123.5%$716,490,8888.7%7,954,045473
Physician Assistant50,26610%$435,105,7525.3%6,074,540121
Ophthalmology11,1572.3%$283,617,2603.4%3,228,442289
Hematology-Oncology7,8891.6%$268,308,8953.3%3,073,372390
Urology8,1981.7%$255,940,9643.1%2,829,906345
Orthopedic Surgery17,2173.6%$245,571,7993.0%2,667,930155
Endocrinology5,7251.2%$189,939,4142.3%2,128,740372
Dermatology10,0132.1%$185,789,7192.3%2,082,440208
Pulmonary Disease7,8421.6%$182,675,7852.2%1,989,124254
Neurology10,5442.2%$180,038,7972.2%2,027,096192
Rheumatology4,6580.97%$165,951,8142.0%1,861,114400
Interventional Cardiology4,0300.84%$152,626,2821.9%1,743,236433

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 2023.

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