HCPCS 99217

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

Evaluation and management Work RVU per service 1.28 (2021 fee schedule)

Billers

28,546

99th percentile among 6,253 codes billed · 2021

Medicare payment on the code

$47M

96th percentile among 6,253 codes billed · 2021

Services

838K

95th percentile among 6,253 codes billed · 2021

Median services per biller

46th percentile among 6,253 codes billed · 2021

95th percentile services per biller

48th percentile among 6,253 codes billed · 2021

Change from prior year

-5.6%

Medicare payment on the code vs 2020; billers -4.1% · 2021

Trend

Medicare payment on the code

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

Billers

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
2022	27,169	$42,298,886	-10%	777,006	22	67	1.28
2021	28,546	$46,766,244	-6%	838,230	22	71	1.28
2020	29,759	$49,559,807	first year in data	879,043	22	70	1.28

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
Florida	2,179	$3,993,212	70,458	24	78
Texas	1,914	$3,058,108	55,479	22	73
California	1,808	$2,797,971	46,134	20	55
Illinois	1,399	$2,527,090	43,780	24	74
New York	1,239	$2,232,898	37,975	21	81
Massachusetts	960	$1,945,664	33,612	25	80
Pennsylvania	1,237	$1,939,800	34,991	21	74
Ohio	1,188	$1,918,623	35,512	23	70
Maryland	720	$1,823,250	31,745	29	119
Michigan	1,084	$1,667,235	30,009	21	67
New Jersey	752	$1,544,675	25,568	24	87
Virginia	884	$1,512,101	26,960	22	70
North Carolina	1,078	$1,506,279	28,076	21	56
Arizona	608	$1,333,065	24,316	26	113
Indiana	721	$1,120,063	21,678	23	69

Not listed: 3 billers with an armed-forces or unknown state code (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 2021.

Top metro areas

	observed	calculated	calculated	calculated
New York-Newark-Jersey City, NY-NJ	1,123	$2,388,190	38,965	24
Chicago-Naperville-Elgin, IL-IN	1,050	$1,929,490	32,981	25
Boston-Cambridge-Newton, MA-NH	611	$1,200,115	20,564	25
Washington-Arlington-Alexandria, DC-VA-MD-WV	520	$1,114,463	19,163	26
Baltimore-Columbia-Towson, MD	412	$986,154	16,981	28
Phoenix-Mesa-Chandler, AZ	390	$951,451	17,354	27
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD	543	$921,291	15,739	22
Houston-Pasadena-The Woodlands, TX	480	$845,936	15,027	23
Miami-Fort Lauderdale-West Palm Beach, FL	450	$844,478	14,374	21
Tampa-St. Petersburg-Clearwater, FL	441	$790,201	14,076	24
Detroit-Warren-Dearborn, MI	470	$782,619	13,670	22
Los Angeles-Long Beach-Anaheim, CA	489	$755,897	12,374	20
Dallas-Fort Worth-Arlington, TX	499	$752,298	13,659	21
Kansas City, MO-KS	224	$422,865	7,744	24
Atlanta-Sandy Springs-Roswell, GA	314	$411,740	7,375	17

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 2021.

Specialties billing 99217 nationally

Internal Medicine accounts for 45% of payment for 99217 nationally in 2021, across 22 specialties on claims.

	observed	calculated	calculated	calculated	calculated	calculated
Internal Medicine	12,579	44%	$20,927,397	45%	367,801	29
Hospitalist	6,874	24%	$11,454,626	24%	201,289	29
Family Practice	3,010	11%	$4,558,102	9.7%	81,965	27
Nurse Practitioner	2,122	7.4%	$3,616,352	7.7%	74,851	35
Physician Assistant	1,328	4.7%	$2,254,403	4.8%	45,370	34
Emergency Medicine	1,261	4.4%	$2,179,899	4.7%	35,244	28
Cardiology	476	1.7%	$574,398	1.2%	10,323	22
Clinical Cardiac Electrophysiology	185	0.65%	$246,114	0.53%	4,303	23
Interventional Cardiology	201	0.70%	$233,766	0.50%	4,239	21
Nephrology	93	0.33%	$119,488	0.26%	2,115	23
General Practice	46	0.16%	$82,317	0.18%	1,513	33
General Surgery	60	0.21%	$63,687	0.14%	1,125	19
Psychiatry	39	0.14%	$61,729	0.13%	1,080	28
Pulmonary Disease	26	0.09%	$59,234	0.13%	1,029	40
Geriatric Medicine	31	0.11%	$51,200	0.11%	901	29

Not listed: 23 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 2021.

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