HCPCS 99215

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

Evaluation and management Work RVU per service 2.80 (2023 fee schedule)

145,531
100th percentile among 6,405 codes billed · 2023
$1.34B
100th percentile among 6,405 codes billed · 2023
11.1M
99th percentile among 6,405 codes billed · 2023
38
67th percentile among 6,405 codes billed · 2023
267
72nd percentile among 6,405 codes billed · 2023
+5.2%
Medicare payment on the code vs 2022; billers +5.8% · 2023

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
California15,361$220,613,7521,650,68948395
Florida8,548$91,155,738727,76341306
New York8,278$83,914,522612,45437254
Texas8,725$80,610,967680,87939279
Illinois6,244$63,028,374510,18642287
Pennsylvania7,165$61,633,357524,44038254
Massachusetts6,356$56,739,726466,68140244
New Jersey3,745$44,968,528328,99140317
Maryland4,067$44,244,075360,26645319
North Carolina5,719$43,871,636392,24236234
Arizona3,267$38,784,868326,32746381
Virginia4,031$38,359,673320,65838286
Washington4,323$36,101,956304,69136240
Ohio4,954$29,465,505275,28331176
Michigan4,417$26,433,650238,86031176

Not listed: 19 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ8,244$101,705,896713,66941
Los Angeles-Long Beach-Anaheim, CA4,988$80,920,711598,34050
Chicago-Naperville-Elgin, IL-IN5,236$56,942,988455,94745
Boston-Cambridge-Newton, MA-NH4,949$44,156,098361,14040
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD3,875$38,956,810319,29644
Washington-Arlington-Alexandria, DC-VA-MD-WV2,897$33,913,808258,45844
San Francisco-Oakland-Fremont, CA2,341$32,650,840235,72852
Phoenix-Mesa-Chandler, AZ2,284$26,878,130224,82645
Baltimore-Columbia-Towson, MD2,563$26,606,552223,10745
Houston-Pasadena-The Woodlands, TX2,418$23,074,401192,72742
Dallas-Fort Worth-Arlington, TX2,572$22,723,020190,37138
Seattle-Tacoma-Bellevue, WA2,692$21,570,109179,08336
San Diego-Chula Vista-Carlsbad, CA1,650$20,858,076160,04347
Miami-Fort Lauderdale-West Palm Beach, FL1,834$19,879,453154,23442
San Jose-Sunnyvale-Santa Clara, CA1,575$19,230,421142,73249

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 99215 nationally

Internal Medicine accounts for 15% of payment for 99215 nationally in 2023, across 70 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine19,26613%$198,336,91815%1,648,27886
Hematology-Oncology6,6424.6%$138,256,73610%1,118,068168
Nurse Practitioner21,83915%$127,695,0489.5%1,267,83458
Family Practice17,58912%$121,688,5779.1%1,040,34959
Cardiology8,5925.9%$117,828,1248.8%896,642104
Neurology8,4355.8%$100,641,2537.5%791,95594
Medical Oncology2,7551.9%$52,486,2523.9%434,081158
Physician Assistant9,4656.5%$47,474,3753.5%471,72350
Pulmonary Disease4,3383.0%$46,523,3493.5%358,39883
Nephrology3,5812.5%$37,564,5632.8%331,01692
Endocrinology3,0232.1%$36,574,0042.7%283,20694
Rheumatology2,4501.7%$26,745,1942.0%211,06486
Interventional Cardiology1,9941.4%$23,167,5141.7%178,75990
Urology3,0202.1%$20,988,5411.6%160,59953
Orthopedic Surgery2,8902.0%$20,187,8451.5%153,26253

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 2023.

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