HCPCS 99309

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

Evaluation and management Work RVU per service 1.92 (2024 fee schedule)

30,091
99th percentile among 6,471 codes billed · 2024
$1.10B
100th percentile among 6,471 codes billed · 2024
14.7M
99th percentile among 6,471 codes billed · 2024
224
90th percentile among 6,471 codes billed · 2024
1,764
90th percentile among 6,471 codes billed · 2024
+19.2%
Medicare payment on the code vs 2023; billers +7.1% · 2024

Trend

Medicare payment on the code

$0$500M$1.00B2020: $646M paid20202021: $641M paid20212022: $685M paid20222023: $924M paid20232024: $1.10B paid2024$1.10B$0$500M$1.00B2020: $646M paid20202021: $641M paid20212022: $685M paid20222023: $924M paid20232024: $1.10B paid2024$1.10B$0$500M$1.00B2020: $646M paid20202021: $641M paid20212022: $685M paid20222023: $924M paid20232024: $1.10B paid2024$1.10B$0$500M$1.00B2020: $646M paid20202021: $641M paid20212022: $685M paid20222023: $924M paid20232024: $1.10B paid2024$1.10B

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

Billers

020K2020: 26K providers20202021: 26K providers20212022: 26K providers20222023: 28K providers20232024: 30K providers202430K020K2020: 26K providers20202021: 26K providers20212022: 26K providers20222023: 28K providers20232024: 30K providers202430K020K2020: 26K providers20202021: 26K providers20212022: 26K providers20222023: 28K providers20232024: 30K providers202430K020K2020: 26K providers20202021: 26K providers20212022: 26K providers20222023: 28K providers20232024: 30K providers202430K

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
202430,091$1,101,657,091+19%14,712,8002241,7641.92
202328,092$924,354,236+35%12,273,1252041,5771.92
202226,291$684,784,757+7%10,623,4661861,4601.55
202125,682$640,927,746-1%9,717,5351761,3661.55
202026,044$646,293,211first year in data9,727,6351721,3511.55

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
Florida2,522$130,169,0461,737,4013452,440
California1,967$117,310,1041,414,5412312,927
New York2,272$108,284,5971,296,0632442,141
Texas1,932$72,778,0291,003,8442511,852
New Jersey1,469$64,744,220786,0042551,918
Pennsylvania1,751$55,201,254739,7132091,463
Illinois1,487$51,601,779681,5162161,597
Maryland841$40,562,650523,0513312,090
Massachusetts896$36,879,478490,1373461,819
Ohio1,482$36,426,325528,8191951,165
Virginia870$33,076,551457,2532961,835
North Carolina988$31,769,558462,8632581,478
Indiana785$27,130,743406,1013071,679
Georgia631$25,184,339352,9802672,016
Tennessee676$21,017,792315,0613111,431

Not listed: 6 billers with an armed-forces or unknown state code (AE, AP, XX, ZZ); they are in the national totals.

Not listed: 3 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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ2,600$133,513,2241,560,245258
Los Angeles-Long Beach-Anaheim, CA922$63,142,174762,310219
Chicago-Naperville-Elgin, IL-IN1,247$49,553,090656,270249
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,001$42,260,073549,724299
Miami-Fort Lauderdale-West Palm Beach, FL665$30,106,877375,088300
Tampa-St. Petersburg-Clearwater, FL454$28,044,215384,389413
Dallas-Fort Worth-Arlington, TX556$26,762,360363,563389
Washington-Arlington-Alexandria, DC-VA-MD-WV588$25,608,482326,943312
Boston-Cambridge-Newton, MA-NH574$24,147,570316,726353
Baltimore-Columbia-Towson, MD459$21,133,522271,555284
Orlando-Kissimmee-Sanford, FL329$19,392,800262,344399
Atlanta-Sandy Springs-Roswell, GA324$16,392,866226,398356
Houston-Pasadena-The Woodlands, TX410$14,565,226198,370236
San Francisco-Oakland-Fremont, CA199$13,295,873149,677301
Phoenix-Mesa-Chandler, AZ343$12,862,401173,088235

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 2024.

Specialties billing 99309 nationally

Nurse Practitioner accounts for 51% of payment for 99309 nationally in 2024, across 37 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner15,52252%$565,241,97851%8,127,388524
Internal Medicine5,09117%$196,949,91418%2,351,412462
Family Practice3,28611%$96,694,6198.8%1,192,109363
Physician Assistant2,0606.8%$75,680,5886.9%1,069,367519
Physical Medicine and Rehabilitation6672.2%$55,039,1685.0%635,077952
Geriatric Medicine5731.9%$15,214,8451.4%186,265325
Hospitalist4871.6%$13,768,5921.2%166,308341
General Practice2260.75%$12,138,7541.1%146,574649
Psychiatry3581.2%$11,066,5031.0%133,498373
General Surgery2120.70%$10,528,4070.96%119,632564
Pulmonary Disease1830.61%$5,849,8070.53%66,038361
Emergency Medicine1690.56%$5,757,7970.52%71,596424
Pain Management340.11%$3,478,6820.32%40,2241,183
Cardiology990.33%$3,334,1200.30%37,168375
Infectious Disease1150.38%$3,291,4060.30%38,295333

Not listed: 28 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 2024.

Top billers of 99309 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