HCPCS 99304

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

Evaluation and management Work RVU per service 1.64 (2021 fee schedule)

3,211
93rd percentile among 6,253 codes billed · 2021
$18M
91st percentile among 6,253 codes billed · 2021
256K
90th percentile among 6,253 codes billed · 2021
38
67th percentile among 6,253 codes billed · 2021
277
74th percentile among 6,253 codes billed · 2021
+15.2%
Medicare payment on the code vs 2020; billers -1.1% · 2021

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 York390$3,050,97338,21351345
Florida347$2,769,52739,28870386
California245$2,335,13631,55249531
New Jersey267$1,712,62623,42544295
Illinois174$806,03111,30532229
Pennsylvania175$761,26210,87835167
Texas143$702,83910,41135274
Ohio145$561,1948,64732197
Michigan107$409,0576,02033172
Maryland75$388,6895,64651201
Virginia69$358,4105,31435276
Connecticut48$331,3924,59635327
Oklahoma42$308,1894,97946428
Missouri75$283,9174,37831199
Massachusetts58$263,7313,56031228

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

Not listed: 12 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-NJ499$4,018,95851,17351
Los Angeles-Long Beach-Anaheim, CA138$1,613,03221,83060
Miami-Fort Lauderdale-West Palm Beach, FL196$1,585,05822,04681
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD130$774,39110,90947
Chicago-Naperville-Elgin, IL-IN125$639,2118,83833
Tampa-St. Petersburg-Clearwater, FL45$456,9546,66066
Washington-Arlington-Alexandria, DC-VA-MD-WV51$327,6824,62244
Detroit-Warren-Dearborn, MI76$320,2454,67939
Orlando-Kissimmee-Sanford, FL22$251,2893,60366
Dallas-Fort Worth-Arlington, TX35$247,4113,60633
San Francisco-Oakland-Fremont, CA19$240,4593,18232
Oklahoma City, OK14$199,9163,207162
Baltimore-Columbia-Towson, MD38$191,4872,79539
Houston-Pasadena-The Woodlands, TX31$181,0462,60338
St. Louis, MO-IL41$166,0312,50031

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 50 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 99304 nationally

Podiatry accounts for 28% of payment for 99304 nationally in 2021, across 20 specialties on claims.

observed calculated calculated calculated calculated calculated
Podiatry64620%$5,121,27428%69,826108
Family Practice65420%$2,998,52517%42,82465
Nurse Practitioner61419%$2,317,05613%37,70761
Physical Medicine and Rehabilitation1986.2%$1,642,8929.1%21,756110
Internal Medicine41013%$1,621,2998.9%22,50155
General Surgery1233.8%$1,141,8666.3%15,370125
Physician Assistant1213.8%$595,5403.3%9,44678
General Practice541.7%$542,6243.0%7,335136
Psychiatry752.3%$442,3262.4%5,98580
Otolaryngology190.59%$354,3772.0%4,568240
Infectious Disease220.69%$151,3080.83%2,00091
Geriatric Medicine381.2%$150,6110.83%2,14056
Pulmonary Disease160.50%$101,7130.56%1,33383
Orthopedic Surgery130.40%$84,4270.47%1,16289
Cardiology180.56%$78,6470.43%1,04758

Not listed: 35 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 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