HCPCS 99307

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

Evaluation and management Work RVU per service 0.76 (2021 fee schedule)

9,641
97th percentile among 6,253 codes billed · 2021
$60M
96th percentile among 6,253 codes billed · 2021
1.8M
97th percentile among 6,253 codes billed · 2021
68
82nd percentile among 6,253 codes billed · 2021
714
85th percentile among 6,253 codes billed · 2021
-6.6%
Medicare payment on the code vs 2020; billers -13.5% · 2021

Trend

Medicare payment on the code

$0$25M$50M2020: $65M paid20202021: $60M paid20212022: $54M paid20222023: $45M paid20232024: $43M paid2024$43M$0$25M$50M2020: $65M paid20202021: $60M paid20212022: $54M paid20222023: $45M paid20232024: $43M paid2024$43M$0$25M$50M2020: $65M paid20202021: $60M paid20212022: $54M paid20222023: $45M paid20232024: $43M paid2024$43M$0$25M$50M2020: $65M paid20202021: $60M paid20212022: $54M paid20222023: $45M paid20232024: $43M paid2024$43M

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

Billers

05,00010K2020: 11K providers20202021: 9,641 providers20212022: 9,118 providers20222023: 8,370 providers20232024: 8,117 providers20248,11705,00010K2020: 11K providers20202021: 9,641 providers20212022: 9,118 providers20222023: 8,370 providers20232024: 8,117 providers20248,11705,00010K2020: 11K providers20202021: 9,641 providers20212022: 9,118 providers20222023: 8,370 providers20232024: 8,117 providers20248,11705,00010K2020: 11K providers20202021: 9,641 providers20212022: 9,118 providers20222023: 8,370 providers20232024: 8,117 providers20248,117

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
20248,117$42,916,895-4%1,476,728676500.70
20238,370$44,923,103-17%1,538,647676800.70
20229,118$54,275,612-10%1,674,952676900.76
20219,641$60,437,717-7%1,826,453687140.76
202011,148$64,686,582first year in data1,975,331666530.76

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 York1,203$12,268,445323,629871,101
California567$6,050,369171,747831,128
Florida792$5,718,495176,16992855
Texas490$4,113,354127,74979962
New Jersey504$3,918,067110,39784851
Illinois442$3,391,675100,02272957
Pennsylvania573$2,406,94173,76258460
Ohio454$2,066,65468,31960519
Michigan342$1,761,40957,94968641
Georgia215$1,384,36445,76568863
Massachusetts250$1,253,06637,72061502
Tennessee205$1,148,90939,44566769
Maryland205$1,147,46833,01866621
Connecticut200$1,082,77832,37583501
Alabama190$1,065,76836,59991599

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

Not listed: 4 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-NJ1,209$13,655,155355,395104
Los Angeles-Long Beach-Anaheim, CA231$3,394,84196,428104
Chicago-Naperville-Elgin, IL-IN350$3,021,77687,74382
Miami-Fort Lauderdale-West Palm Beach, FL317$2,077,48259,89487
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD308$1,366,20439,87761
Detroit-Warren-Dearborn, MI186$1,086,38235,16078
Dallas-Fort Worth-Arlington, TX125$1,058,37433,234106
Boston-Cambridge-Newton, MA-NH155$817,55024,28270
Atlanta-Sandy Springs-Roswell, GA93$761,19924,60264
Houston-Pasadena-The Woodlands, TX99$684,10620,47479
Washington-Arlington-Alexandria, DC-VA-MD-WV121$633,92917,85563
San Francisco-Oakland-Fremont, CA92$624,91616,36065
Baltimore-Columbia-Towson, MD103$622,10218,06174
Riverside-San Bernardino-Ontario, CA46$577,47216,65762
Tampa-St. Petersburg-Clearwater, FL102$537,39617,05993

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 87 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 99307 nationally

Nurse Practitioner accounts for 24% of payment for 99307 nationally in 2021, across 25 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner3,16633%$14,557,51324%494,860156
Internal Medicine1,74618%$13,601,90223%381,075218
Family Practice1,65517%$8,964,37515%275,990167
Podiatry1,17212%$8,224,16714%237,930203
Physician Assistant4825.0%$2,521,0074.2%85,068176
Physical Medicine and Rehabilitation2352.4%$2,481,0854.1%69,637296
Psychiatry2212.3%$2,171,0993.6%64,397291
General Practice1141.2%$1,089,4381.8%29,987263
Pulmonary Disease600.62%$1,062,9121.8%29,541492
General Surgery1321.4%$978,9751.6%26,695202
Geriatric Medicine1441.5%$955,6441.6%26,963187
Emergency Medicine710.74%$729,8581.2%19,607276
Pediatric Medicine140.15%$545,5360.90%12,910922
Hospitalist830.86%$378,9760.63%10,615128
Cardiology250.26%$220,3850.36%6,358254

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 2021.

Top billers of 99307 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