HCPCS 99239

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

Evaluation and management Work RVU per service 1.90 (2021 fee schedule)

57,251
100th percentile among 6,253 codes billed · 2021
$368M
99th percentile among 6,253 codes billed · 2021
4.4M
98th percentile among 6,253 codes billed · 2021
56
77th percentile among 6,253 codes billed · 2021
202
69th percentile among 6,253 codes billed · 2021
-2.2%
Medicare payment on the code vs 2020; billers +2.2% · 2021

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
California4,487$32,531,032359,69658213
Florida3,857$31,078,322364,69074245
Texas3,848$26,194,488316,79862208
New York3,189$20,728,297229,60452194
Illinois2,546$18,616,524216,72866215
Pennsylvania2,855$17,348,617208,17356187
Ohio2,556$14,899,919182,64652185
New Jersey1,463$12,734,890140,04565270
Massachusetts1,875$12,258,449139,48645215
Michigan2,075$12,028,522142,89652171
North Carolina2,241$11,571,292142,18446159
Virginia1,411$10,876,338128,58774233
Georgia1,719$10,407,585126,91757174
Maryland1,075$8,479,38696,72868231
Missouri1,177$7,956,38697,69065208

Not listed: 8 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ2,841$21,904,703234,96757
Chicago-Naperville-Elgin, IL-IN1,946$14,317,100164,99764
Los Angeles-Long Beach-Anaheim, CA1,453$10,266,231112,89653
Boston-Cambridge-Newton, MA-NH1,284$7,813,25987,83839
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,104$7,768,28487,93155
Dallas-Fort Worth-Arlington, TX1,065$7,078,06585,02762
Washington-Arlington-Alexandria, DC-VA-MD-WV828$6,746,75775,66375
Houston-Pasadena-The Woodlands, TX1,008$6,508,30077,18657
Tampa-St. Petersburg-Clearwater, FL742$6,055,01171,64382
Detroit-Warren-Dearborn, MI867$5,937,98869,17958
Miami-Fort Lauderdale-West Palm Beach, FL847$5,765,23265,63658
Phoenix-Mesa-Chandler, AZ826$5,493,61266,82261
Atlanta-Sandy Springs-Roswell, GA892$5,180,20762,24853
Baltimore-Columbia-Towson, MD684$4,867,11555,52658
San Francisco-Oakland-Fremont, CA621$4,218,32644,16451

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 2021.

Specialties billing 99239 nationally

Internal Medicine accounts for 50% of payment for 99239 nationally in 2021, across 36 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine24,50643%$184,629,55850%2,162,23388
Hospitalist12,22321%$93,870,67826%1,098,60790
Family Practice5,5819.7%$33,262,4139.0%395,56471
Nurse Practitioner4,0847.1%$13,793,6113.8%193,47347
Physical Medicine and Rehabilitation1,4382.5%$11,574,6963.1%136,48695
Psychiatry1,9803.5%$7,005,7251.9%82,92142
Physician Assistant2,1003.7%$6,612,0581.8%92,44844
Cardiology1,0841.9%$2,675,9700.73%30,93629
Emergency Medicine3090.54%$2,020,1920.55%24,23078
Nephrology3660.64%$1,586,2190.43%18,62351
Pulmonary Disease4370.76%$1,452,3120.40%16,92539
General Surgery4730.83%$1,042,3340.28%12,31926
Neurology3440.60%$995,3230.27%11,60334
Hematology-Oncology3980.70%$917,7510.25%10,62527
Geriatric Medicine1540.27%$772,0200.21%8,76957

Not listed: 26 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 2021.

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