HCPCS 99239

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

Evaluation and management Work RVU per service 1.90 (2020 fee schedule)

56,028
100th percentile among 6,116 codes billed · 2020
$376M
99th percentile among 6,116 codes billed · 2020
4.4M
98th percentile among 6,116 codes billed · 2020
56
79th percentile among 6,116 codes billed · 2020
211
70th percentile among 6,116 codes billed · 2020

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
California4,327$32,387,946352,90458221
Florida3,699$31,106,472359,92874260
Texas3,708$26,913,698320,01062226
New York3,200$20,681,947228,53852194
Illinois2,509$19,145,075219,68468220
Pennsylvania2,776$17,054,865200,62354187
Ohio2,491$15,086,574181,65352191
Michigan1,980$12,552,528147,74256193
North Carolina2,188$12,429,547150,71650178
Massachusetts1,882$12,315,799137,80144214
New Jersey1,480$11,734,408128,21657245
Virginia1,343$11,247,954130,98880249
Georgia1,652$11,230,158133,58263196
Maryland1,092$8,505,72295,86370228
Missouri1,145$8,270,610100,88869219

Not listed: 7 billers with an armed-forces or unknown state code (AA, 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ2,902$21,020,649224,82252
Chicago-Naperville-Elgin, IL-IN1,888$14,562,173165,44669
Los Angeles-Long Beach-Anaheim, CA1,372$9,893,013107,36952
Boston-Cambridge-Newton, MA-NH1,298$7,750,99185,65136
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,077$7,464,58983,49454
Dallas-Fort Worth-Arlington, TX1,025$7,401,14187,34762
Houston-Pasadena-The Woodlands, TX937$6,505,59776,34757
Washington-Arlington-Alexandria, DC-VA-MD-WV764$6,445,74571,66881
Detroit-Warren-Dearborn, MI841$6,285,85172,63166
Tampa-St. Petersburg-Clearwater, FL699$6,215,98672,17085
Miami-Fort Lauderdale-West Palm Beach, FL801$5,873,26266,13359
Phoenix-Mesa-Chandler, AZ805$5,749,34968,64765
Atlanta-Sandy Springs-Roswell, GA862$5,568,35065,31857
Baltimore-Columbia-Towson, MD704$5,088,62157,22459
San Francisco-Oakland-Fremont, CA574$4,109,16041,86256

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 99239 nationally

Internal Medicine accounts for 51% of payment for 99239 nationally in 2020, across 35 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine24,44944%$192,253,25651%2,219,93291
Hospitalist11,33820%$92,027,01124%1,062,38394
Family Practice5,5279.9%$34,108,6179.1%399,07172
Nurse Practitioner3,7926.8%$13,705,2553.6%189,53650
Physical Medicine and Rehabilitation1,3792.5%$11,171,5353.0%130,29394
Psychiatry2,1303.8%$8,316,8282.2%97,26546
Physician Assistant1,8893.4%$6,281,1061.7%86,37746
Cardiology1,0891.9%$2,704,8640.72%31,00628
Emergency Medicine3010.54%$2,150,2520.57%25,22084
Nephrology4020.72%$1,951,4200.52%22,70856
Pulmonary Disease5220.93%$1,869,8220.50%21,67242
Neurology3480.62%$1,022,0930.27%11,76334
General Surgery4500.80%$986,4730.26%11,50626
Hematology-Oncology4100.73%$916,2390.24%10,55626
Geriatric Medicine1650.29%$802,3020.21%9,16556

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 2020.

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