HCPCS 99215

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

Evaluation and management Work RVU per service 2.80 (2022 fee schedule)

137,554
100th percentile among 6,326 codes billed · 2022
$1.27B
100th percentile among 6,326 codes billed · 2022
10.3M
99th percentile among 6,326 codes billed · 2022
37
66th percentile among 6,326 codes billed · 2022
262
73rd percentile among 6,326 codes billed · 2022
+1.0%
Medicare payment on the code vs 2021; billers +3.2% · 2022

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
California14,352$204,999,5981,510,79647391
Florida8,183$85,421,495668,53039294
New York7,934$80,258,034571,62836244
Texas8,102$79,033,198651,59339286
Illinois5,974$60,994,520479,73141281
Pennsylvania6,739$58,377,634481,85236241
Massachusetts5,849$51,807,932413,18939233
North Carolina5,482$44,017,888383,92836244
Maryland3,817$42,860,879331,87244308
New Jersey3,524$42,466,087304,48841326
Arizona3,141$35,787,477295,46044354
Virginia3,702$35,033,355283,83437282
Washington4,027$34,316,446284,52736236
Ohio4,754$29,098,529264,68930179
Michigan4,293$27,033,102238,56731179

Not listed: 17 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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ7,770$95,692,618653,47340
Los Angeles-Long Beach-Anaheim, CA4,689$76,336,694553,02748
Chicago-Naperville-Elgin, IL-IN4,990$54,614,348424,86844
Boston-Cambridge-Newton, MA-NH4,570$40,498,649321,03239
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD3,589$36,168,234286,82541
Washington-Arlington-Alexandria, DC-VA-MD-WV2,722$33,198,610242,40943
San Francisco-Oakland-Fremont, CA2,238$30,195,498217,43651
Baltimore-Columbia-Towson, MD2,370$24,745,389197,56344
Phoenix-Mesa-Chandler, AZ2,174$24,388,692200,86045
Houston-Pasadena-The Woodlands, TX2,218$22,545,783183,06743
Dallas-Fort Worth-Arlington, TX2,342$21,558,476176,46538
Seattle-Tacoma-Bellevue, WA2,500$20,260,559164,95636
Miami-Fort Lauderdale-West Palm Beach, FL1,818$19,439,383147,33640
San Diego-Chula Vista-Carlsbad, CA1,500$18,927,265142,28546
San Jose-Sunnyvale-Santa Clara, CA1,425$16,958,334124,34946

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 2022.

Specialties billing 99215 nationally

Internal Medicine accounts for 15% of payment for 99215 nationally in 2022, across 69 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine18,97014%$195,679,14615%1,601,23784
Hematology-Oncology6,4454.7%$132,171,22210%1,043,044162
Family Practice17,36913%$119,994,7379.4%1,012,36258
Cardiology8,5646.2%$114,591,5909.0%858,951100
Nurse Practitioner19,01214%$108,871,9348.5%1,057,99356
Neurology8,3406.1%$98,431,8617.7%759,19791
Medical Oncology2,6541.9%$49,950,6163.9%403,592152
Pulmonary Disease4,0142.9%$41,718,7663.3%314,29778
Physician Assistant8,0665.9%$40,483,6073.2%392,47149
Nephrology3,4152.5%$35,775,8822.8%297,84487
Endocrinology2,9242.1%$35,635,3472.8%271,02493
Rheumatology2,3021.7%$25,012,6092.0%194,46984
Interventional Cardiology1,9501.4%$22,357,7931.8%170,58587
Urology2,9612.2%$20,310,2971.6%152,18651
Psychiatry1,9481.4%$19,990,4791.6%162,70384

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 2022.

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