HCPCS 99239

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

Evaluation and management Work RVU per service 1.90 (2022 fee schedule)

58,097
100th percentile among 6,326 codes billed · 2022
$356M
99th percentile among 6,326 codes billed · 2022
4.3M
98th percentile among 6,326 codes billed · 2022
54
77th percentile among 6,326 codes billed · 2022
199
69th percentile among 6,326 codes billed · 2022
-3.2%
Medicare payment on the code vs 2021; billers +1.5% · 2022

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
California4,617$33,318,402376,57458225
Florida3,996$31,169,212376,29672246
Texas3,952$26,613,328331,17461216
New York3,243$20,592,404232,30751197
Illinois2,521$17,556,360209,31965206
Pennsylvania2,961$16,810,488207,20854178
Ohio2,526$13,395,160168,65248176
New Jersey1,499$12,597,815142,35466268
Massachusetts1,927$11,666,883136,68043208
Michigan2,095$10,845,680132,44547164
Virginia1,469$10,750,429130,66568226
North Carolina2,205$10,642,218134,71846157
Georgia1,712$9,927,553124,34957174
Maryland1,084$7,987,40392,54361222
Missouri1,210$7,802,04998,09664196

Not listed: 8 billers with an armed-forces or unknown state code (AA, AP, FM, 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-NJ2,943$22,144,051242,92156
Chicago-Naperville-Elgin, IL-IN1,919$13,755,393162,46266
Los Angeles-Long Beach-Anaheim, CA1,496$10,847,293122,21556
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,142$7,884,94891,86758
Boston-Cambridge-Newton, MA-NH1,315$7,443,80686,26536
Dallas-Fort Worth-Arlington, TX1,088$7,280,87790,21464
Houston-Pasadena-The Woodlands, TX1,065$6,740,29582,06657
Washington-Arlington-Alexandria, DC-VA-MD-WV824$6,375,63473,43672
Tampa-St. Petersburg-Clearwater, FL758$5,883,18271,57678
Miami-Fort Lauderdale-West Palm Beach, FL834$5,818,29768,03762
Detroit-Warren-Dearborn, MI848$5,403,46364,74958
Phoenix-Mesa-Chandler, AZ854$5,389,97766,99259
Atlanta-Sandy Springs-Roswell, GA867$4,863,41460,01150
Baltimore-Columbia-Towson, MD688$4,472,96451,94251
San Francisco-Oakland-Fremont, CA598$4,222,63345,31555

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 99239 nationally

Internal Medicine accounts for 50% of payment for 99239 nationally in 2022, across 37 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine24,69042%$176,426,04150%2,117,60186
Hospitalist12,87322%$94,282,10026%1,129,66088
Family Practice5,4339.4%$31,923,8529.0%388,77772
Nurse Practitioner4,5017.7%$14,010,7223.9%201,91045
Physical Medicine and Rehabilitation1,4282.5%$11,751,2543.3%142,02299
Physician Assistant2,3824.1%$6,821,1461.9%97,95541
Psychiatry1,8083.1%$5,411,3601.5%65,68736
Cardiology9881.7%$2,266,5260.64%26,84927
Emergency Medicine2990.51%$1,972,7780.55%24,29281
Nephrology3340.57%$1,418,5480.40%16,98051
Pulmonary Disease4210.72%$1,269,7690.36%15,12536
Neurology3420.59%$886,0180.25%10,53031
General Surgery3820.66%$825,6040.23%9,98526
Hematology-Oncology3520.61%$767,3310.22%9,08826
Geriatric Medicine1640.28%$731,6890.21%8,47352

Not listed: 25 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 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