HCPCS 99239

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

Evaluation and management Work RVU per service 2.15 (2023 fee schedule)

62,398
100th percentile among 6,405 codes billed · 2023
$447M
99th percentile among 6,405 codes billed · 2023
5.0M
99th percentile among 6,405 codes billed · 2023
57
77th percentile among 6,405 codes billed · 2023
223
69th percentile among 6,405 codes billed · 2023
+25.7%
Medicare payment on the code vs 2022; billers +7.4% · 2023

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
California5,050$41,848,123439,52561239
Florida4,165$39,769,828443,24983275
Texas4,197$32,779,491377,65866238
New York3,458$24,460,308257,00350215
Illinois2,612$21,932,647241,01968232
Pennsylvania3,252$21,382,035244,94557197
Ohio2,741$16,918,993197,92752190
New Jersey1,714$16,282,905171,68771287
Massachusetts2,016$14,334,513156,65241244
Virginia1,608$13,582,918153,27770257
North Carolina2,379$13,214,647156,12448172
Michigan2,223$12,967,496146,34046174
Georgia1,906$12,446,041144,08756189
Maryland1,194$10,794,405118,27969268
Arizona1,233$10,323,449118,80173266

Not listed: 6 billers with an armed-forces or unknown state code (AA, FM, ZZ); they are in the national totals.

Not listed: 3 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-NJ3,245$26,914,233275,20956
Chicago-Naperville-Elgin, IL-IN1,996$17,425,464189,77969
Los Angeles-Long Beach-Anaheim, CA1,620$13,556,560142,15862
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,339$10,338,353112,44660
Boston-Cambridge-Newton, MA-NH1,357$8,949,67996,70333
Dallas-Fort Worth-Arlington, TX1,128$8,885,652102,15472
Houston-Pasadena-The Woodlands, TX1,159$8,546,68696,47759
Washington-Arlington-Alexandria, DC-VA-MD-WV881$8,202,09288,48178
Phoenix-Mesa-Chandler, AZ925$7,698,12588,53569
Miami-Fort Lauderdale-West Palm Beach, FL842$7,471,17380,33274
Tampa-St. Petersburg-Clearwater, FL774$7,107,45479,60084
Detroit-Warren-Dearborn, MI901$6,250,69869,06355
Baltimore-Columbia-Towson, MD768$6,149,57767,02259
Atlanta-Sandy Springs-Roswell, GA972$6,049,72269,28749
San Francisco-Oakland-Fremont, CA639$5,347,85352,97060

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 99239 nationally

Internal Medicine accounts for 49% of payment for 99239 nationally in 2023, across 35 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine25,73941%$218,747,53049%2,432,97895
Hospitalist13,58822%$120,518,03227%1,337,82498
Family Practice5,8079.3%$39,838,9058.9%449,95077
Nurse Practitioner5,3948.6%$20,306,4374.5%270,95850
Physical Medicine and Rehabilitation1,4752.4%$13,488,5723.0%150,336102
Physician Assistant2,9854.8%$10,460,5042.3%138,93047
Psychiatry1,7712.8%$5,315,1321.2%59,53934
Emergency Medicine5990.96%$2,983,4610.67%33,42956
Cardiology1,0551.7%$2,622,6540.59%28,78127
Nephrology3070.49%$1,465,0030.33%16,18353
Pulmonary Disease4240.68%$1,285,3620.29%14,26034
General Surgery4710.75%$1,158,6110.26%12,85527
Neurology3740.60%$1,066,0590.24%11,71031
General Practice1160.19%$938,4370.21%10,34889
Interventional Cardiology3730.60%$890,9350.20%9,99227

Not listed: 29 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 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