HCPCS 99217

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

Evaluation and management Work RVU per service 1.28 (2020 fee schedule)

29,759
99th percentile among 6,116 codes billed · 2020
$50M
96th percentile among 6,116 codes billed · 2020
879K
95th percentile among 6,116 codes billed · 2020
22
47th percentile among 6,116 codes billed · 2020
70
49th percentile among 6,116 codes billed · 2020

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
Florida2,271$4,367,11075,8922680
Texas1,950$3,288,79258,8602373
California1,658$2,572,24641,9592052
Illinois1,397$2,400,38541,5362367
New York1,304$2,178,75537,1392168
Pennsylvania1,360$2,120,58537,5692068
Ohio1,255$2,117,54238,4332277
Maryland731$1,901,49032,89330116
North Carolina1,187$1,810,16433,5132261
Massachusetts929$1,805,73630,8292580
Michigan1,080$1,705,75030,1202263
Virginia865$1,542,28527,3012473
Arizona694$1,508,53927,10027111
New Jersey721$1,332,51922,5562378
Missouri712$1,215,15222,1292571

Not listed: 7 billers with an armed-forces or unknown state code (AA, AP, PW, XX, 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,101$2,019,20933,20222
Chicago-Naperville-Elgin, IL-IN998$1,763,20430,22024
Boston-Cambridge-Newton, MA-NH591$1,124,22918,99424
Phoenix-Mesa-Chandler, AZ465$1,057,25118,99728
Baltimore-Columbia-Towson, MD418$1,051,84017,94630
Washington-Arlington-Alexandria, DC-VA-MD-WV493$1,043,56317,78327
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD580$972,88316,43321
Miami-Fort Lauderdale-West Palm Beach, FL457$900,83515,06724
Tampa-St. Petersburg-Clearwater, FL442$886,22815,45029
Houston-Pasadena-The Woodlands, TX475$863,77915,15825
Dallas-Fort Worth-Arlington, TX499$832,36014,83122
Detroit-Warren-Dearborn, MI468$772,55613,30722
Los Angeles-Long Beach-Anaheim, CA455$669,40010,78420
Atlanta-Sandy Springs-Roswell, GA366$483,8708,50018
Charlotte-Concord-Gastonia, NC-SC290$481,8488,88725

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 2020.

Specialties billing 99217 nationally

Internal Medicine accounts for 46% of payment for 99217 nationally in 2020, across 21 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine13,39745%$22,915,99746%398,42130
Hospitalist6,88323%$11,615,24623%202,03629
Family Practice3,25711%$5,191,71810%91,97728
Nurse Practitioner2,1547.2%$3,689,8737.4%75,36435
Physician Assistant1,2874.3%$2,242,8044.5%44,70135
Emergency Medicine1,1273.8%$1,732,4653.5%28,18425
Cardiology6342.1%$791,6461.6%14,09822
Clinical Cardiac Electrophysiology2150.72%$288,5520.58%5,04223
Interventional Cardiology2480.83%$278,7480.56%4,93220
Nephrology1050.35%$150,5720.30%2,63225
General Practice450.15%$93,0950.19%1,65637
Pulmonary Disease460.15%$85,8070.17%1,47832
General Surgery680.23%$73,6170.15%1,29319
Geriatric Medicine340.11%$58,3200.12%1,01730
Pediatric Medicine320.11%$53,6820.11%94530

Not listed: 29 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 2020.

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