HCPCS 99239

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

Evaluation and management Work RVU per service 2.15 (2024 fee schedule)

64,431
100th percentile among 6,471 codes billed · 2024
$455M
99th percentile among 6,471 codes billed · 2024
5.2M
99th percentile among 6,471 codes billed · 2024
57
75th percentile among 6,471 codes billed · 2024
222
69th percentile among 6,471 codes billed · 2024
+1.7%
Medicare payment on the code vs 2023; billers +3.3% · 2024

Trend

Medicare payment on the code

$0$200M$400M2020: $376M paid20202021: $368M paid20212022: $356M paid20222023: $447M paid20232024: $455M paid2024$455M$0$200M$400M2020: $376M paid20202021: $368M paid20212022: $356M paid20222023: $447M paid20232024: $455M paid2024$455M$0$200M$400M2020: $376M paid20202021: $368M paid20212022: $356M paid20222023: $447M paid20232024: $455M paid2024$455M$0$200M$400M2020: $376M paid20202021: $368M paid20212022: $356M paid20222023: $447M paid20232024: $455M paid2024$455M

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

Billers

025K50K2020: 56K providers20202021: 57K providers20212022: 58K providers20222023: 62K providers20232024: 64K providers202464K025K50K2020: 56K providers20202021: 57K providers20212022: 58K providers20222023: 62K providers20232024: 64K providers202464K025K50K2020: 56K providers20202021: 57K providers20212022: 58K providers20222023: 62K providers20232024: 64K providers202464K025K50K2020: 56K providers20202021: 57K providers20212022: 58K providers20222023: 62K providers20232024: 64K providers202464K

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
202464,431$454,832,692+2%5,221,363572222.15
202362,398$447,174,015+26%5,045,473572232.15
202258,097$355,822,267-3%4,325,899541991.90
202157,251$367,610,766-2%4,359,408562021.90
202056,028$376,041,147first year in data4,395,652562111.90

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
California5,251$44,666,603478,84365248
Florida4,397$40,333,172458,27181271
Texas4,326$33,528,144391,29466234
New York3,546$24,572,933262,89450211
Illinois2,752$22,256,860249,58765236
Pennsylvania3,381$21,938,143256,62958199
Ohio2,821$17,135,903204,63354186
New Jersey1,756$16,664,324178,53174278
Massachusetts2,125$14,449,663160,68340234
Virginia1,625$13,705,934157,46376247
North Carolina2,431$12,902,434155,54846163
Michigan2,281$12,826,230147,32145177
Georgia1,984$12,817,029150,09454183
Maryland1,186$10,762,788120,57670264
Arizona1,257$10,435,742122,42573251

Not listed: 10 billers with an armed-forces or unknown state code (AA, AE, AP, FM, 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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ3,334$27,598,176288,45659
Chicago-Naperville-Elgin, IL-IN2,107$17,704,111196,48266
Los Angeles-Long Beach-Anaheim, CA1,635$14,354,584154,53367
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,405$10,452,548115,67659
Dallas-Fort Worth-Arlington, TX1,191$9,320,266108,42172
Boston-Cambridge-Newton, MA-NH1,461$9,121,388100,25934
Houston-Pasadena-The Woodlands, TX1,213$8,788,204100,81860
Washington-Arlington-Alexandria, DC-VA-MD-WV910$8,063,10788,89574
Miami-Fort Lauderdale-West Palm Beach, FL967$7,833,96386,22064
Phoenix-Mesa-Chandler, AZ936$7,751,50790,87673
Tampa-St. Petersburg-Clearwater, FL803$6,935,28579,01282
Atlanta-Sandy Springs-Roswell, GA1,029$6,254,76272,17146
Baltimore-Columbia-Towson, MD755$6,249,12969,65158
Detroit-Warren-Dearborn, MI911$5,992,97567,71552
San Francisco-Oakland-Fremont, CA659$5,461,60954,54657

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 2024.

Specialties billing 99239 nationally

Internal Medicine accounts for 49% of payment for 99239 nationally in 2024, across 36 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine26,37441%$222,912,30449%2,524,48196
Hospitalist14,21922%$123,039,60227%1,385,71797
Family Practice5,8199.0%$39,993,6708.8%459,00179
Nurse Practitioner5,8709.1%$21,293,2484.7%288,52949
Physical Medicine and Rehabilitation1,5182.4%$13,724,6973.0%156,270103
Physician Assistant3,2995.1%$10,967,0072.4%147,82645
Psychiatry1,6942.6%$4,885,3401.1%55,80533
Emergency Medicine5830.90%$2,971,9560.65%33,96358
Cardiology9931.5%$2,295,8670.50%25,62126
Nephrology2860.44%$1,380,6840.30%15,55354
General Surgery5330.83%$1,249,3630.27%14,13727
Pulmonary Disease4150.64%$1,159,5780.25%13,22332
Neurology3950.61%$1,041,8250.23%11,62129
Interventional Cardiology3820.59%$894,3130.20%10,15827
General Practice1090.17%$872,2950.19%10,00492

Not listed: 27 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 2024.

Top billers of 99239 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