HCPCS 99217

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

Evaluation and management Work RVU per service 1.28 (2022 fee schedule)

27,169
99th percentile among 6,326 codes billed · 2022
$42M
95th percentile among 6,326 codes billed · 2022
777K
95th percentile among 6,326 codes billed · 2022
22
45th percentile among 6,326 codes billed · 2022
67
46th percentile among 6,326 codes billed · 2022
-9.6%
Medicare payment on the code vs 2021; billers -4.8% · 2022

Trend

Medicare payment on the code

$0$20M$40M2020: $50M paid20202021: $47M paid20212022: $42M paid2022$42M$0$20M$40M2020: $50M paid20202021: $47M paid20212022: $42M paid2022$42M$0$20M$40M2020: $50M paid20202021: $47M paid20212022: $42M paid2022$42M$0$20M$40M2020: $50M paid20202021: $47M paid20212022: $42M paid2022$42M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2022.

Billers

020K2020: 30K providers20202021: 29K providers20212022: 27K providers202227K020K2020: 30K providers20202021: 29K providers20212022: 27K providers202227K020K2020: 30K providers20202021: 29K providers20212022: 27K providers202227K020K2020: 30K providers20202021: 29K providers20212022: 27K providers202227K

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2022.

observed calculated calculated calculated calculated calculated reported
202227,169$42,298,886-10%777,00622671.28
202128,546$46,766,244-6%838,23022711.28
202029,759$49,559,807first year in data879,04322701.28

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2022.

By state

observed calculated calculated calculated calculated calculated
Florida2,134$3,779,17568,2342477
Texas1,826$3,022,13156,4292377
California1,778$2,736,56246,0572155
Illinois1,337$2,254,92740,0522372
New York1,223$2,087,95536,1372271
Massachusetts1,027$1,817,77931,9612471
Pennsylvania1,197$1,712,27131,7452061
Maryland675$1,670,99629,72432113
Ohio1,117$1,621,59930,9262263
New Jersey785$1,468,44625,3032385
Michigan953$1,333,85224,7442060
Virginia776$1,321,10124,0762372
Arizona627$1,289,38224,06924124
North Carolina996$1,253,54823,9902053
Indiana675$972,98619,3332266

Not listed: 4 billers with an armed-forces or unknown state code (AA, AP, ZZ); they are in the national totals.

Not listed: 2 states 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-NJ1,185$2,255,44237,98323
Chicago-Naperville-Elgin, IL-IN1,040$1,768,45231,04324
Boston-Cambridge-Newton, MA-NH645$1,116,77519,41524
Washington-Arlington-Alexandria, DC-VA-MD-WV492$1,055,77518,59529
Phoenix-Mesa-Chandler, AZ418$960,57117,94327
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD560$912,76116,04522
Miami-Fort Lauderdale-West Palm Beach, FL464$902,03615,56523
Baltimore-Columbia-Towson, MD382$891,97215,75830
Los Angeles-Long Beach-Anaheim, CA557$827,60213,84320
Houston-Pasadena-The Woodlands, TX457$814,78914,95426
Dallas-Fort Worth-Arlington, TX495$748,94713,93323
Tampa-St. Petersburg-Clearwater, FL413$740,94113,53726
Detroit-Warren-Dearborn, MI411$625,88411,23021
Kansas City, MO-KS229$387,4107,27224
Louisville/Jefferson County, KY-IN192$373,1327,25231

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 99217 nationally

Internal Medicine accounts for 44% of payment for 99217 nationally in 2022, across 22 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine11,76543%$18,635,20044%335,71229
Hospitalist6,84925%$10,794,07226%194,57728
Family Practice2,6929.9%$3,973,4449.4%73,25527
Nurse Practitioner2,0967.7%$3,239,2627.7%68,76333
Physician Assistant1,3324.9%$2,199,0345.2%45,27834
Emergency Medicine1,3785.1%$2,177,1035.1%36,13526
Cardiology3251.2%$362,4870.86%6,64120
Clinical Cardiac Electrophysiology1390.51%$172,2180.41%3,07322
Interventional Cardiology1440.53%$142,0500.34%2,63318
Nephrology730.27%$83,4000.20%1,51021
General Practice440.16%$73,1720.17%1,33430
General Surgery570.21%$61,4980.15%1,08519
Pulmonary Disease260.10%$54,6330.13%97638
Psychiatry350.13%$53,3320.13%94727
Geriatric Medicine270.10%$50,0660.12%89033

Not listed: 25 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 99217 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