HCPCS 99222

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

Evaluation and management Work RVU per service 2.61 (2020 fee schedule)

98,326
100th percentile among 6,116 codes billed · 2020
$529M
100th percentile among 6,116 codes billed · 2020
4.8M
99th percentile among 6,116 codes billed · 2020
28
58th percentile among 6,116 codes billed · 2020
153
65th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$200M$400M2020: $529M paid20202021: $489M paid20212022: $440M paid20222023: $543M paid20232024: $528M paid2024$528M$0$200M$400M2020: $529M paid20202021: $489M paid20212022: $440M paid20222023: $543M paid20232024: $528M paid2024$528M$0$200M$400M2020: $529M paid20202021: $489M paid20212022: $440M paid20222023: $543M paid20232024: $528M paid2024$528M$0$200M$400M2020: $529M paid20202021: $489M paid20212022: $440M paid20222023: $543M paid20232024: $528M paid2024$528M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

050K100K2020: 98K providers20202021: 95K providers20212022: 91K providers20222023: 118K providers20232024: 116K providers2024116K050K100K2020: 98K providers20202021: 95K providers20212022: 91K providers20222023: 118K providers20232024: 116K providers2024116K050K100K2020: 98K providers20202021: 95K providers20212022: 91K providers20222023: 118K providers20232024: 116K providers2024116K050K100K2020: 98K providers20202021: 95K providers20212022: 91K providers20222023: 118K providers20232024: 116K providers2024116K

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
2024115,957$528,263,761-3%5,366,122271402.60
2023117,621$542,990,235+23%5,434,960271402.60
202291,293$440,423,233-10%4,198,865271422.61
202195,113$489,225,504-7%4,567,046281492.61
202098,326$528,723,342first year in data4,835,349281532.61

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
Florida7,269$51,100,190458,89635213
New York6,500$41,528,826342,42428170
Texas6,975$41,120,638387,83531179
California5,531$33,031,199286,25427174
Pennsylvania6,289$30,467,583278,18228126
Illinois4,938$29,156,750259,33631165
New Jersey3,748$27,383,382235,63034215
Michigan4,018$26,839,477241,93831211
Ohio4,651$23,173,965219,57529140
Massachusetts3,167$15,637,506138,18327132
Virginia2,649$13,566,731123,90429137
Missouri2,624$12,558,698118,36927138
Indiana2,446$12,545,895122,93532151
Georgia2,686$12,507,258117,90827123
North Carolina2,978$11,760,902112,79224108

Not listed: 17 billers with an armed-forces or unknown state code (AA, AE, 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-NJ6,890$51,365,977419,82931
Chicago-Naperville-Elgin, IL-IN3,873$24,864,752220,17132
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD3,233$18,934,276165,40332
Detroit-Warren-Dearborn, MI2,100$17,689,777156,47838
Los Angeles-Long Beach-Anaheim, CA2,036$15,963,559136,81031
Miami-Fort Lauderdale-West Palm Beach, FL1,781$14,326,830123,86337
Houston-Pasadena-The Woodlands, TX1,723$12,135,035111,49335
Boston-Cambridge-Newton, MA-NH2,250$10,488,23791,68726
Dallas-Fort Worth-Arlington, TX1,893$10,372,28297,54629
Washington-Arlington-Alexandria, DC-VA-MD-WV1,361$7,923,24868,45930
Orlando-Kissimmee-Sanford, FL918$7,405,57267,63040
Tampa-St. Petersburg-Clearwater, FL1,115$7,360,48566,86136
St. Louis, MO-IL1,344$6,795,69063,11127
Cleveland, OH1,197$6,355,84560,24628
Atlanta-Sandy Springs-Roswell, GA1,335$5,732,47353,01126

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 99222 nationally

Internal Medicine accounts for 17% of payment for 99222 nationally in 2020, across 63 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine16,09516%$88,964,50317%806,29250
Cardiology8,1568.3%$54,189,58210%485,97660
Infectious Disease3,5193.6%$41,726,4247.9%369,377105
Nephrology5,0645.2%$41,222,5857.8%370,30773
Gastroenterology6,3826.5%$38,489,1857.3%345,36754
Nurse Practitioner7,1527.3%$28,761,1685.4%310,35443
General Surgery6,5416.7%$23,333,6604.4%212,32632
Family Practice5,2195.3%$22,913,8204.3%213,73141
Hospitalist5,4395.5%$22,196,8124.2%201,97037
Pulmonary Disease3,1373.2%$19,024,3733.6%170,37954
Neurology3,2653.3%$18,574,9573.5%167,17551
Physical Medicine and Rehabilitation1,6651.7%$18,220,2873.4%164,01099
Psychiatry2,0322.1%$11,141,9382.1%101,88650
Interventional Cardiology1,8401.9%$10,801,8782.0%98,35653
Physician Assistant3,1883.2%$10,623,5772.0%114,08136

Not listed: 11 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 99222 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