HCPCS 99215

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

Evaluation and management Work RVU per service 2.80 (2024 fee schedule)

153,625
100th percentile among 6,471 codes billed · 2024
$1.42B
100th percentile among 6,471 codes billed · 2024
11.8M
99th percentile among 6,471 codes billed · 2024
38
65th percentile among 6,471 codes billed · 2024
268
71st percentile among 6,471 codes billed · 2024
+6.2%
Medicare payment on the code vs 2023; billers +5.6% · 2024

Trend

Medicare payment on the code

$0$1.00B2020: $786M paid20202021: $1.26B paid20212022: $1.27B paid20222023: $1.34B paid20232024: $1.42B paid2024$1.42B$0$1.00B2020: $786M paid20202021: $1.26B paid20212022: $1.27B paid20222023: $1.34B paid20232024: $1.42B paid2024$1.42B$0$1.00B2020: $786M paid20202021: $1.26B paid20212022: $1.27B paid20222023: $1.34B paid20232024: $1.42B paid2024$1.42B$0$1.00B2020: $786M paid20202021: $1.26B paid20212022: $1.27B paid20222023: $1.34B paid20232024: $1.42B paid2024$1.42B

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

Billers

0100K2020: 108K providers20202021: 133K providers20212022: 138K providers20222023: 146K providers20232024: 154K providers2024154K0100K2020: 108K providers20202021: 133K providers20212022: 138K providers20222023: 146K providers20232024: 154K providers2024154K0100K2020: 108K providers20202021: 133K providers20212022: 138K providers20222023: 146K providers20232024: 154K providers2024154K0100K2020: 108K providers20202021: 133K providers20212022: 138K providers20222023: 146K providers20232024: 154K providers2024154K

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
2024153,625$1,424,342,188+6%11,827,816382682.80
2023145,531$1,340,835,499+5%11,126,975382672.80
2022137,554$1,274,511,973+1%10,345,559372622.80
2021133,298$1,261,370,854+60%9,935,165372602.80
2020107,887$786,264,171first year in data7,848,467352562.11

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
California16,401$242,207,0691,805,31350400
Florida9,027$96,818,726769,93241302
New York8,864$89,181,342651,77538251
Texas9,267$84,607,594713,08139279
Illinois6,669$67,073,676540,48642275
Pennsylvania7,664$65,240,423562,54838259
Massachusetts6,960$64,018,344527,72241259
New Jersey3,952$48,708,685355,69241337
North Carolina6,014$44,657,940405,79637225
Maryland4,183$44,004,472367,97445319
Arizona3,479$40,371,215335,83346344
Virginia4,290$39,762,203336,96240281
Washington4,398$35,961,243300,72036227
Ohio5,331$31,924,284300,57033187
Colorado3,400$28,092,002252,01441246

Not listed: 15 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-NJ8,852$109,704,350770,26543
Los Angeles-Long Beach-Anaheim, CA5,367$86,390,275640,97851
Chicago-Naperville-Elgin, IL-IN5,639$61,369,009488,80845
Boston-Cambridge-Newton, MA-NH5,450$50,519,903413,84742
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD4,086$40,466,327335,68143
San Francisco-Oakland-Fremont, CA2,525$37,211,504266,19153
Washington-Arlington-Alexandria, DC-VA-MD-WV3,099$34,551,716267,59243
Phoenix-Mesa-Chandler, AZ2,434$27,869,377230,15346
Baltimore-Columbia-Towson, MD2,637$27,025,462230,87746
Dallas-Fort Worth-Arlington, TX2,795$25,459,698211,48939
San Diego-Chula Vista-Carlsbad, CA1,819$25,094,028189,53050
Houston-Pasadena-The Woodlands, TX2,630$24,065,698200,59040
San Jose-Sunnyvale-Santa Clara, CA1,660$22,771,388160,47952
Seattle-Tacoma-Bellevue, WA2,716$21,496,824175,93235
Miami-Fort Lauderdale-West Palm Beach, FL1,937$20,726,681161,85442

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 99215 nationally

Internal Medicine accounts for 14% of payment for 99215 nationally in 2024, across 73 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine19,22113%$198,806,77614%1,649,03786
Nurse Practitioner24,92916%$151,162,18411%1,493,25060
Hematology-Oncology6,9584.5%$149,180,46810%1,209,292174
Family Practice17,92112%$124,796,4458.8%1,064,17559
Cardiology8,7205.7%$117,858,3758.3%900,099103
Neurology8,7495.7%$106,468,3107.5%835,18295
Medical Oncology2,8431.9%$55,518,7713.9%459,135161
Physician Assistant10,6646.9%$55,422,3883.9%547,38151
Pulmonary Disease4,5603.0%$49,824,2213.5%383,97384
Nephrology3,6862.4%$40,474,8322.8%349,93395
Endocrinology3,1782.1%$38,283,0892.7%297,19094
Rheumatology2,7011.8%$29,290,7752.1%229,47985
Interventional Cardiology2,1381.4%$23,761,7961.7%183,56686
Urology3,1752.1%$23,614,9161.7%180,63757
Orthopedic Surgery3,1622.1%$21,538,4491.5%164,31352

Not listed: 6 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 99215 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