HCPCS 99222

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

Evaluation and management Work RVU per service 2.60 (2023 fee schedule)

117,621
100th percentile among 6,405 codes billed · 2023
$543M
100th percentile among 6,405 codes billed · 2023
5.4M
99th percentile among 6,405 codes billed · 2023
27
55th percentile among 6,405 codes billed · 2023
140
62nd percentile among 6,405 codes billed · 2023
+23.3%
Medicare payment on the code vs 2022; billers +28.8% · 2023

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
Florida8,974$54,150,352533,18834194
New York7,874$46,147,208412,36128163
Texas7,912$38,472,848395,67129153
California7,346$36,737,347347,73026148
Pennsylvania7,852$33,409,480336,86527122
Illinois5,732$30,250,596294,80931159
New Jersey4,365$29,184,629273,85635209
Michigan4,810$24,050,255238,15529156
Ohio5,478$23,004,463240,13328127
Massachusetts3,420$15,283,934150,05826135
Virginia3,120$13,642,655137,76328129
Missouri3,098$13,180,372136,31927131
Georgia3,080$12,035,579125,16727121
Indiana2,799$11,523,659123,88427131
North Carolina3,335$11,070,431116,9482398

Not listed: 17 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ8,362$57,019,198506,55032
Chicago-Naperville-Elgin, IL-IN4,506$24,790,102239,98531
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD3,987$20,310,928195,88231
Los Angeles-Long Beach-Anaheim, CA2,496$16,104,596151,29730
Detroit-Warren-Dearborn, MI2,437$14,846,674143,70432
Miami-Fort Lauderdale-West Palm Beach, FL2,185$14,415,604135,71233
Houston-Pasadena-The Woodlands, TX2,167$10,862,570108,27529
Boston-Cambridge-Newton, MA-NH2,408$10,127,51098,09125
Dallas-Fort Worth-Arlington, TX2,083$9,765,786100,76728
Washington-Arlington-Alexandria, DC-VA-MD-WV1,731$8,457,30880,97629
Tampa-St. Petersburg-Clearwater, FL1,446$8,024,19380,68834
St. Louis, MO-IL1,680$7,395,77075,20727
Orlando-Kissimmee-Sanford, FL1,059$7,041,61770,41735
Phoenix-Mesa-Chandler, AZ1,528$6,485,40367,37628
Cleveland, OH1,405$6,264,70365,28129

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 99222 nationally

Internal Medicine accounts for 18% of payment for 99222 nationally in 2023, across 64 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine19,23416%$99,146,20418%978,57551
Cardiology8,7317.4%$50,998,4989.4%497,95157
Hospitalist8,6127.3%$40,108,8527.4%399,04046
Nurse Practitioner11,1549.5%$39,074,5887.2%459,73741
Gastroenterology6,5365.6%$33,265,7806.1%323,98850
Infectious Disease3,5563.0%$33,091,3826.1%316,70989
Nephrology4,9764.2%$30,474,8325.6%296,53360
General Surgery7,6756.5%$24,736,5214.6%245,50832
Family Practice5,6394.8%$23,160,9404.3%235,10142
Neurology3,8093.2%$20,034,3783.7%196,06851
Physician Assistant6,0125.1%$17,627,4563.2%205,83534
Physical Medicine and Rehabilitation1,7361.5%$17,619,6353.2%171,62699
Pulmonary Disease3,1332.7%$14,513,7502.7%140,30645
Interventional Cardiology2,1151.8%$11,475,3742.1%113,98454
Urology3,1142.6%$10,817,8632.0%105,42534

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 2023.

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