HCPCS 99304

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

Evaluation and management Work RVU per service 1.64 (2022 fee schedule)

3,302
93rd percentile among 6,326 codes billed · 2022
$19M
92nd percentile among 6,326 codes billed · 2022
274K
91st percentile among 6,326 codes billed · 2022
39
68th percentile among 6,326 codes billed · 2022
304
75th percentile among 6,326 codes billed · 2022
+4.1%
Medicare payment on the code vs 2021; billers +2.8% · 2022

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 York400$3,199,79941,38145394
Florida382$3,000,44943,37074392
California247$2,444,71134,01648526
New Jersey255$1,597,87522,48242336
Texas174$838,60612,61136271
Illinois147$801,51111,52141298
Pennsylvania183$788,17811,59036193
Ohio164$618,5049,83036194
Maryland80$362,7665,23438214
Virginia68$329,6265,08139238
Connecticut48$327,3664,63640392
Michigan101$323,0254,94628134
Indiana87$309,3405,12131206
Missouri70$292,6654,66236219
Oklahoma45$276,6224,69549298

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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ505$4,009,85252,51047
Los Angeles-Long Beach-Anaheim, CA139$1,784,92924,77073
Miami-Fort Lauderdale-West Palm Beach, FL204$1,660,82623,32481
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD137$814,85111,76243
Chicago-Naperville-Elgin, IL-IN118$707,07710,09743
Tampa-St. Petersburg-Clearwater, FL56$488,2107,32359
Dallas-Fort Worth-Arlington, TX62$424,4556,28455
Washington-Arlington-Alexandria, DC-VA-MD-WV51$315,0034,49755
Orlando-Kissimmee-Sanford, FL23$303,4554,44199
Detroit-Warren-Dearborn, MI67$241,9333,67830
San Francisco-Oakland-Fremont, CA19$201,1292,71237
Houston-Pasadena-The Woodlands, TX31$171,5082,51830
Oklahoma City, OK22$164,2362,76555
Boston-Cambridge-Newton, MA-NH31$159,1422,27542
Baltimore-Columbia-Towson, MD42$155,8352,27129

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 2022.

Specialties billing 99304 nationally

Podiatry accounts for 29% of payment for 99304 nationally in 2022, across 19 specialties on claims.

observed calculated calculated calculated calculated calculated
Podiatry69621%$5,483,04629%76,671110
Family Practice58118%$2,954,40316%42,77874
Nurse Practitioner79224%$2,880,92815%48,40261
Internal Medicine39612%$1,455,0727.7%20,64052
Physical Medicine and Rehabilitation1604.8%$1,444,3667.6%19,460122
General Surgery1314.0%$1,200,8466.4%16,702127
Physician Assistant1474.5%$664,7023.5%10,80173
Otolaryngology150.45%$473,4232.5%6,246416
General Practice491.5%$461,0362.4%6,498133
Psychiatry581.8%$374,1722.0%5,10588
Plastic and Reconstructive Surgery210.64%$203,9881.1%2,787133
Geriatric Medicine351.1%$157,7780.84%2,27065
Infectious Disease210.64%$139,2800.74%1,92392
Pulmonary Disease170.51%$121,8580.65%1,66498
Ophthalmology110.33%$93,4600.49%1,195109

Not listed: 31 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 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