HCPCS 99284

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

Evaluation and management Work RVU per service 2.60 (2020 fee schedule)

59,468
100th percentile among 6,116 codes billed · 2020
$348M
99th percentile among 6,116 codes billed · 2020
3.9M
98th percentile among 6,116 codes billed · 2020
51
77th percentile among 6,116 codes billed · 2020
166
66th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$200M$400M2020: $348M paid20202021: $368M paid20212022: $363M paid20222023: $423M paid20232024: $375M paid2024$375M$0$200M$400M2020: $348M paid20202021: $368M paid20212022: $363M paid20222023: $423M paid20232024: $375M paid2024$375M$0$200M$400M2020: $348M paid20202021: $368M paid20212022: $363M paid20222023: $423M paid20232024: $375M paid2024$375M$0$200M$400M2020: $348M paid20202021: $368M paid20212022: $363M paid20222023: $423M paid20232024: $375M paid2024$375M

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

Billers

025K50K2020: 59K providers20202021: 59K providers20212022: 61K providers20222023: 64K providers20232024: 65K providers202465K025K50K2020: 59K providers20202021: 59K providers20212022: 61K providers20222023: 64K providers20232024: 65K providers202465K025K50K2020: 59K providers20202021: 59K providers20212022: 61K providers20222023: 64K providers20232024: 65K providers202465K025K50K2020: 59K providers20202021: 59K providers20212022: 61K providers20222023: 64K providers20232024: 65K providers202465K

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
202465,448$374,843,174-11%4,389,227531702.74
202364,306$423,199,423+16%4,773,623601852.74
202260,502$363,363,427-1%3,909,961501652.74
202159,298$368,046,210+6%3,899,328521662.74
202059,468$348,455,248first year in data3,888,994511662.60

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
California4,906$24,652,885268,42042141
New York3,910$21,969,264221,89445140
Pennsylvania3,120$21,343,595236,83662188
Texas4,161$19,669,784224,11542137
Florida3,565$18,469,299199,08944139
Illinois2,478$16,082,312173,35157171
Michigan2,564$14,968,438161,72155141
Ohio2,623$14,839,402167,91553147
North Carolina2,099$12,992,983152,29358185
Massachusetts1,528$12,803,195136,03271225
Virginia1,492$10,210,855115,35861197
Maryland1,177$8,649,80192,90056224
Georgia1,790$8,562,18797,75544129
New Jersey1,508$8,484,90088,76447144
South Carolina1,077$7,787,45291,55770207

Not listed: 25 billers with an armed-forces or unknown state code (AA, AE, AP, 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-NJ3,590$20,744,427201,39044
Chicago-Naperville-Elgin, IL-IN1,786$11,041,033116,72953
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,504$10,172,816107,31158
Boston-Cambridge-Newton, MA-NH956$7,593,90279,94369
Detroit-Warren-Dearborn, MI1,245$7,351,42977,40654
Los Angeles-Long Beach-Anaheim, CA1,424$5,931,16163,80534
Washington-Arlington-Alexandria, DC-VA-MD-WV850$5,276,41556,69050
Baltimore-Columbia-Towson, MD710$4,927,50151,87752
Dallas-Fort Worth-Arlington, TX1,032$4,756,40854,45444
Miami-Fort Lauderdale-West Palm Beach, FL885$4,335,83644,15937
Atlanta-Sandy Springs-Roswell, GA850$3,673,71441,10239
San Francisco-Oakland-Fremont, CA630$3,548,11037,47150
Houston-Pasadena-The Woodlands, TX884$3,268,93536,06834
Minneapolis-St. Paul-Bloomington, MN-WI722$3,118,08835,57846
Phoenix-Mesa-Chandler, AZ634$3,019,83434,98541

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 99284 nationally

Emergency Medicine accounts for 75% of payment for 99284 nationally in 2020, across 29 specialties on claims.

observed calculated calculated calculated calculated calculated
Emergency Medicine38,67465%$261,247,91075%2,813,92973
Physician Assistant10,02317%$37,629,15111%484,44748
Nurse Practitioner5,4939.2%$20,713,7395.9%271,03749
Family Practice2,5164.2%$16,317,4954.7%182,49173
Internal Medicine1,0071.7%$6,417,5651.8%69,59869
General Surgery3770.63%$1,259,9430.36%13,39236
General Practice1920.32%$945,1070.27%10,48255
Psychiatry2060.35%$553,7700.16%5,92029
Cardiology1550.26%$373,3630.11%3,88825
Hospitalist770.13%$338,6000.10%3,73849
Neurology1280.22%$304,9530.09%3,11024
Pediatric Medicine540.09%$300,3860.09%3,27861
Critical Care (Intensivists)800.13%$295,2230.08%3,09139
Osteopathic Manipulative Medicine340.06%$234,0800.07%2,57476
Ophthalmology360.06%$150,1620.04%1,60645

Not listed: 34 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 99284 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