HCPCS 99220

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

Evaluation and management Work RVU per service 3.56 (2020 fee schedule)

29,384
99th percentile among 6,116 codes billed · 2020
$152M
98th percentile among 6,116 codes billed · 2020
1.1M
96th percentile among 6,116 codes billed · 2020
24
52nd percentile among 6,116 codes billed · 2020
98
56th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$100M2020: $152M paid20202021: $153M paid20212022: $144M paid2022$144M$0$100M2020: $152M paid20202021: $153M paid20212022: $144M paid2022$144M$0$100M2020: $152M paid20202021: $153M paid20212022: $144M paid2022$144M$0$100M2020: $152M paid20202021: $153M paid20212022: $144M paid2022$144M

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

Billers

020K2020: 29K providers20202021: 29K providers20212022: 29K providers202229K020K2020: 29K providers20202021: 29K providers20212022: 29K providers202229K020K2020: 29K providers20202021: 29K providers20212022: 29K providers202229K020K2020: 29K providers20202021: 29K providers20212022: 29K providers202229K

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
202228,518$144,213,289-6%1,051,915241043.56
202129,208$153,320,802+1%1,081,807251043.56
202029,384$152,136,368first year in data1,055,79924983.56

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
Florida2,683$15,240,886104,92227110
Texas1,938$10,273,04272,60226104
California1,927$9,781,12063,2592482
Pennsylvania1,419$7,097,64049,2382395
Illinois1,303$6,935,49447,76824103
Ohio1,344$6,878,51948,7772695
Maryland771$6,780,24245,91134194
New York1,203$6,077,87040,1252290
Michigan1,117$5,723,13239,8522593
New Jersey860$5,600,11035,95726127
North Carolina1,071$4,848,95835,2962386
Massachusetts941$4,800,38731,3042490
Arizona787$4,784,53933,76729130
Virginia804$4,152,11128,7792497
Tennessee812$3,790,20927,6072585

Not listed: 6 billers with an armed-forces or unknown state code (AE, AP, 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-NJ1,218$7,799,14249,31326
Chicago-Naperville-Elgin, IL-IN1,023$5,454,27337,22324
Baltimore-Columbia-Towson, MD465$3,881,97326,05433
Washington-Arlington-Alexandria, DC-VA-MD-WV497$3,618,76724,29730
Miami-Fort Lauderdale-West Palm Beach, FL642$3,602,75223,64626
Phoenix-Mesa-Chandler, AZ569$3,445,35324,25929
Boston-Cambridge-Newton, MA-NH601$3,310,17721,00724
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD645$3,188,76321,39322
Tampa-St. Petersburg-Clearwater, FL548$3,064,02521,35927
Los Angeles-Long Beach-Anaheim, CA607$3,029,80119,34024
Detroit-Warren-Dearborn, MI572$2,973,05720,34825
Houston-Pasadena-The Woodlands, TX511$2,811,09319,56127
Dallas-Fort Worth-Arlington, TX540$2,806,58719,73125
Atlanta-Sandy Springs-Roswell, GA368$1,575,39210,87922
St. Louis, MO-IL273$1,502,06010,99223

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 99220 nationally

Internal Medicine accounts for 45% of payment for 99220 nationally in 2020, across 25 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine12,81244%$69,141,62545%473,78337
Hospitalist6,89823%$36,909,26424%253,09237
Family Practice2,4398.3%$12,188,6658.0%84,75535
Nurse Practitioner2,0647.0%$10,055,8076.6%80,73939
Emergency Medicine1,9376.6%$9,991,9356.6%62,58732
Physician Assistant1,2414.2%$6,267,2094.1%48,55739
Cardiology6722.3%$2,504,8701.6%17,43426
Neurology2410.82%$1,014,5420.67%7,01229
Nephrology1880.64%$831,1160.55%5,65630
Interventional Cardiology1780.61%$589,4710.39%4,07023
Pulmonary Disease750.26%$337,3780.22%2,31031
Clinical Cardiac Electrophysiology790.27%$321,3570.21%2,16827
General Surgery1180.40%$320,0490.21%2,20419
Infectious Disease480.16%$229,3380.15%1,57233
Geriatric Medicine480.16%$162,0480.11%1,13024

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 99220 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