HCPCS 99221
Evaluation and management service (ClaimLight category; the code descriptor is not shown)
Evaluation and management Work RVU per service 1.63 (2023 fee schedule)
Trend
Medicare payment on the code
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.
Billers
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 | |
|---|---|---|---|---|---|---|---|
| 2024 | 18,351 | $34,109,187 | -11% | 555,578 | 20 | 82 | 1.63 |
| 2023 | 20,230 | $38,288,473 | -45% | 609,409 | 20 | 83 | 1.63 |
| 2022 | 30,696 | $69,484,246 | -9% | 899,594 | 19 | 79 | 1.92 |
| 2021 | 32,541 | $76,455,271 | -8% | 972,269 | 20 | 79 | 1.92 |
| 2020 | 34,099 | $83,287,557 | first year in data | 1,041,608 | 20 | 83 | 1.92 |
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 | |
|---|---|---|---|---|---|---|
| New York | 1,652 | $4,272,301 | 59,735 | 20 | 114 | |
| Florida | 1,693 | $3,657,229 | 56,949 | 22 | 96 | |
| Pennsylvania | 1,496 | $2,560,987 | 40,891 | 19 | 66 | |
| Texas | 1,130 | $2,216,349 | 36,015 | 21 | 92 | |
| Ohio | 1,218 | $2,188,818 | 36,384 | 20 | 80 | |
| Illinois | 1,026 | $2,096,001 | 32,557 | 21 | 87 | |
| California | 992 | $1,871,580 | 27,982 | 19 | 74 | |
| New Jersey | 754 | $1,730,941 | 26,131 | 21 | 114 | |
| Massachusetts | 626 | $1,174,917 | 18,169 | 19 | 78 | |
| Michigan | 592 | $1,145,719 | 17,963 | 19 | 85 | |
| Virginia | 561 | $983,809 | 16,034 | 20 | 78 | |
| Missouri | 504 | $944,912 | 15,526 | 19 | 79 | |
| Georgia | 559 | $910,301 | 15,036 | 20 | 68 | |
| Kentucky | 467 | $860,842 | 14,542 | 20 | 92 | |
| Maryland | 393 | $826,987 | 12,832 | 20 | 89 |
Not listed: 5 billers with an armed-forces or unknown state code (AE, 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 2023.
Top metro areas
| observed | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|
| New York-Newark-Jersey City, NY-NJ | 1,632 | $4,494,230 | 62,135 | 21 | |
| Chicago-Naperville-Elgin, IL-IN | 806 | $1,702,978 | 26,309 | 21 | |
| Philadelphia-Camden-Wilmington, PA-NJ-DE-MD | 707 | $1,462,331 | 22,555 | 20 | |
| Boston-Cambridge-Newton, MA-NH | 423 | $822,847 | 12,515 | 19 | |
| Cleveland, OH | 376 | $800,492 | 13,466 | 21 | |
| Houston-Pasadena-The Woodlands, TX | 364 | $740,464 | 11,601 | 21 | |
| Miami-Fort Lauderdale-West Palm Beach, FL | 283 | $690,656 | 10,090 | 19 | |
| Los Angeles-Long Beach-Anaheim, CA | 333 | $681,171 | 10,087 | 21 | |
| Detroit-Warren-Dearborn, MI | 236 | $586,120 | 8,870 | 19 | |
| Orlando-Kissimmee-Sanford, FL | 234 | $561,467 | 8,918 | 24 | |
| Pittsburgh, PA | 356 | $558,728 | 9,061 | 19 | |
| St. Louis, MO-IL | 252 | $532,704 | 8,499 | 20 | |
| Dallas-Fort Worth-Arlington, TX | 239 | $477,722 | 7,796 | 21 | |
| Baltimore-Columbia-Towson, MD | 212 | $471,649 | 7,205 | 20 | |
| Washington-Arlington-Alexandria, DC-VA-MD-WV | 234 | $464,248 | 7,067 | 20 |
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 99221 nationally
Nurse Practitioner accounts for 13% of payment for 99221 nationally in 2023, across 51 specialties on claims.
| observed | calculated | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|---|
| Nurse Practitioner | 2,642 | 13% | $4,896,849 | 13% | 90,033 | 34 |
| General Surgery | 2,160 | 11% | $3,523,013 | 9.2% | 54,808 | 25 |
| Internal Medicine | 1,436 | 7.1% | $3,157,868 | 8.2% | 48,714 | 34 |
| Gastroenterology | 1,311 | 6.5% | $2,703,439 | 7.1% | 41,728 | 32 |
| Physician Assistant | 1,758 | 8.7% | $2,526,874 | 6.6% | 45,609 | 26 |
| Cardiology | 985 | 4.9% | $2,059,982 | 5.4% | 31,641 | 32 |
| Urology | 1,111 | 5.5% | $1,928,021 | 5.0% | 29,440 | 26 |
| Orthopedic Surgery | 1,136 | 5.6% | $1,774,839 | 4.6% | 27,589 | 24 |
| Neurology | 675 | 3.3% | $1,471,098 | 3.8% | 22,449 | 33 |
| Neurosurgery | 635 | 3.1% | $1,158,779 | 3.0% | 18,015 | 28 |
| Physical Medicine and Rehabilitation | 304 | 1.5% | $1,147,017 | 3.0% | 16,854 | 55 |
| Vascular Surgery | 508 | 2.5% | $1,055,970 | 2.8% | 15,892 | 31 |
| Infectious Disease | 377 | 1.9% | $1,044,656 | 2.7% | 15,623 | 41 |
| Family Practice | 477 | 2.4% | $1,018,349 | 2.7% | 16,292 | 34 |
| Psychiatry | 480 | 2.4% | $979,921 | 2.6% | 15,109 | 31 |
Not listed: 19 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 99221 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