HCPCS 99222

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

Evaluation and management Work RVU per service 2.61 (2022 fee schedule)

91,293
100th percentile among 6,326 codes billed · 2022
$440M
99th percentile among 6,326 codes billed · 2022
4.2M
98th percentile among 6,326 codes billed · 2022
27
55th percentile among 6,326 codes billed · 2022
142
63rd percentile among 6,326 codes billed · 2022
-10.0%
Medicare payment on the code vs 2021; billers -4.0% · 2022

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
Florida6,978$44,382,016416,76332197
New York6,266$40,500,127339,02328174
Texas6,326$32,364,248319,79028163
California5,391$29,715,360268,31126164
Pennsylvania5,987$25,845,624249,18527117
Illinois4,652$25,319,894235,23030156
New Jersey3,571$24,975,942223,37934218
Michigan3,831$21,711,856205,75929176
Ohio4,255$18,203,721181,09327126
Massachusetts2,926$13,018,881121,23925121
Virginia2,435$10,826,084104,17327121
Missouri2,413$9,916,06598,28225122
Indiana2,360$9,840,521101,74727133
Georgia2,380$9,421,48794,29826115
Maryland1,648$8,558,73378,65727153

Not listed: 18 billers with an armed-forces or unknown state code (AA, 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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ6,748$50,697,057424,28131
Chicago-Naperville-Elgin, IL-IN3,678$21,361,141197,44431
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD2,975$15,948,405146,94231
Detroit-Warren-Dearborn, MI1,986$14,257,819132,15135
Los Angeles-Long Beach-Anaheim, CA1,989$14,183,555126,68229
Miami-Fort Lauderdale-West Palm Beach, FL1,721$12,504,654112,44133
Houston-Pasadena-The Woodlands, TX1,704$9,562,40691,37929
Boston-Cambridge-Newton, MA-NH2,111$8,766,48780,55924
Dallas-Fort Worth-Arlington, TX1,675$8,272,57781,61729
Washington-Arlington-Alexandria, DC-VA-MD-WV1,346$6,979,84163,00728
Orlando-Kissimmee-Sanford, FL914$6,405,51261,25836
Tampa-St. Petersburg-Clearwater, FL1,073$6,175,65559,04729
St. Louis, MO-IL1,315$5,814,11456,57425
Cleveland, OH1,062$5,031,30349,69628
Pittsburgh, PA1,235$4,645,78945,56825

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 2022.

Specialties billing 99222 nationally

Internal Medicine accounts for 16% of payment for 99222 nationally in 2022, across 62 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine13,27515%$68,297,58716%640,19048
Cardiology7,6958.4%$46,511,60711%434,27456
Infectious Disease3,3333.7%$34,449,6157.8%314,73494
Gastroenterology5,9966.6%$31,141,7307.1%291,23249
Nephrology4,6165.1%$31,089,9847.1%290,17363
Nurse Practitioner8,1208.9%$29,087,6866.6%328,33740
Hospitalist5,1105.6%$19,987,8434.5%188,97537
General Surgery6,1856.8%$19,753,3414.5%187,87930
Physical Medicine and Rehabilitation1,5911.7%$16,876,9463.8%157,54099
Family Practice4,2534.7%$16,826,2273.8%163,20438
Neurology3,0473.3%$16,221,0683.7%151,24950
Pulmonary Disease2,6672.9%$14,125,4283.2%130,68549
Physician Assistant3,8654.2%$11,475,3932.6%128,52933
Interventional Cardiology1,8772.1%$9,635,8622.2%91,79749
Urology2,4242.7%$9,025,9712.0%84,22135

Not listed: 10 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 2022.

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