HCPCS 99304

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

Evaluation and management Work RVU per service 1.64 (2020 fee schedule)

3,246
93rd percentile among 6,116 codes billed · 2020
$16M
91st percentile among 6,116 codes billed · 2020
220K
90th percentile among 6,116 codes billed · 2020
33
64th percentile among 6,116 codes billed · 2020
244
72nd percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$10M$20M2020: $16M paid20202021: $18M paid20212022: $19M paid20222023: $18M paid20232024: $19M paid2024$19M$0$10M$20M2020: $16M paid20202021: $18M paid20212022: $19M paid20222023: $18M paid20232024: $19M paid2024$19M$0$10M$20M2020: $16M paid20202021: $18M paid20212022: $19M paid20222023: $18M paid20232024: $19M paid2024$19M$0$10M$20M2020: $16M paid20202021: $18M paid20212022: $19M paid20222023: $18M paid20232024: $19M paid2024$19M

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

Billers

02,0002020: 3,246 providers20202021: 3,211 providers20212022: 3,302 providers20222023: 3,303 providers20232024: 3,429 providers20243,42902,0002020: 3,246 providers20202021: 3,211 providers20212022: 3,302 providers20222023: 3,303 providers20232024: 3,429 providers20243,42902,0002020: 3,246 providers20202021: 3,211 providers20212022: 3,302 providers20222023: 3,303 providers20232024: 3,429 providers20243,42902,0002020: 3,246 providers20202021: 3,211 providers20212022: 3,302 providers20222023: 3,303 providers20232024: 3,429 providers20243,429

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
20243,429$18,715,232+6%313,203443081.50
20233,303$17,682,279-6%286,458413081.50
20223,302$18,881,227+4%273,791393041.64
20213,211$18,137,549+15%255,524382771.64
20203,246$15,744,200first year in data219,913332441.64

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
New York397$2,559,55132,08042272
Florida365$2,552,08835,66661309
California243$1,718,40623,14743339
New Jersey267$1,554,25121,33236278
Illinois171$768,66910,52531251
Pennsylvania175$692,1169,67833172
Texas166$665,4849,65631185
Ohio134$445,6106,71330191
Michigan108$362,6845,25229158
Connecticut40$308,7654,40130415
Maryland69$300,2264,19033217
Missouri75$285,7594,26837167
Virginia73$277,9743,95124286
Massachusetts60$264,7313,74935216
Indiana72$262,5204,03935171

Not listed: 2 billers with an armed-forces or unknown state code (XX); they are in the national totals.

Not listed: 11 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-NJ502$3,469,95144,27644
Miami-Fort Lauderdale-West Palm Beach, FL206$1,553,28721,14274
Los Angeles-Long Beach-Anaheim, CA135$1,249,44316,69059
Chicago-Naperville-Elgin, IL-IN121$624,0168,40633
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD125$577,3498,10534
Tampa-St. Petersburg-Clearwater, FL56$394,3775,74751
Washington-Arlington-Alexandria, DC-VA-MD-WV65$340,6454,70328
Detroit-Warren-Dearborn, MI77$283,7784,08830
Orlando-Kissimmee-Sanford, FL24$236,9693,46164
Dallas-Fort Worth-Arlington, TX40$222,6823,19130
Houston-Pasadena-The Woodlands, TX40$195,8792,79534
Hartford-West Hartford-East Hartford, CT18$172,8352,60470
San Francisco-Oakland-Fremont, CA28$170,9372,30025
St. Louis, MO-IL42$160,9392,37631
Oklahoma City, OK21$144,1242,32755

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 46 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 99304 nationally

Podiatry accounts for 25% of payment for 99304 nationally in 2020, across 21 specialties on claims.

observed calculated calculated calculated calculated calculated
Podiatry61819%$3,906,43125%53,25886
Family Practice66320%$2,853,17318%39,76860
Nurse Practitioner50215%$1,749,60511%28,42757
Internal Medicine48915%$1,703,64211%23,43148
Physical Medicine and Rehabilitation2096.4%$1,652,25210%21,662104
General Surgery1273.9%$920,5385.8%12,34197
Physician Assistant1213.7%$488,0003.1%7,70864
General Practice441.4%$421,8252.7%5,725130
Psychiatry702.2%$370,0672.4%5,08773
Otolaryngology190.59%$219,1841.4%2,896152
Geriatric Medicine531.6%$175,8941.1%2,46947
Urology160.49%$138,8860.88%1,749109
Infectious Disease220.68%$123,8230.79%1,72478
Emergency Medicine240.74%$96,5580.61%1,27753
Plastic and Reconstructive Surgery270.83%$85,6010.54%1,17043

Not listed: 32 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 99304 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