HCPCS 99310

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

Evaluation and management Work RVU per service 2.35 (2020 fee schedule)

10,266
97th percentile among 6,116 codes billed · 2020
$156M
98th percentile among 6,116 codes billed · 2020
1.6M
97th percentile among 6,116 codes billed · 2020
68
82nd percentile among 6,116 codes billed · 2020
579
83rd percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$100M$200M2020: $156M paid20202021: $158M paid20212022: $171M paid20222023: $205M paid20232024: $226M paid2024$226M$0$100M$200M2020: $156M paid20202021: $158M paid20212022: $171M paid20222023: $205M paid20232024: $226M paid2024$226M$0$100M$200M2020: $156M paid20202021: $158M paid20212022: $171M paid20222023: $205M paid20232024: $226M paid2024$226M$0$100M$200M2020: $156M paid20202021: $158M paid20212022: $171M paid20222023: $205M paid20232024: $226M paid2024$226M

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

Billers

05,00010K15K2020: 10K providers20202021: 10K providers20212022: 11K providers20222023: 12K providers20232024: 14K providers202414K05,00010K15K2020: 10K providers20202021: 10K providers20212022: 11K providers20222023: 12K providers20232024: 14K providers202414K05,00010K15K2020: 10K providers20202021: 10K providers20212022: 11K providers20222023: 12K providers20232024: 14K providers202414K05,00010K15K2020: 10K providers20202021: 10K providers20212022: 11K providers20222023: 12K providers20232024: 14K providers202414K

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
202413,634$225,517,156+10%2,124,063715442.80
202312,486$204,627,759+20%1,899,369695372.80
202211,116$170,816,263+8%1,816,461735952.35
202110,489$157,980,542+1%1,628,637705732.35
202010,266$155,743,177first year in data1,589,034685792.35

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
California726$17,808,214163,37686806
Texas780$15,052,165158,05497766
Florida779$12,864,002128,74868582
Illinois627$8,687,86289,58663535
Pennsylvania593$7,172,63573,95254500
New Jersey420$6,470,59559,43660558
Massachusetts489$6,320,89963,01669425
Washington240$5,794,95059,8651011,003
Arizona190$5,310,60353,207801,312
New York393$4,728,47944,44448382
Michigan340$4,626,58448,69754584
South Carolina220$4,488,54249,26598909
Colorado252$4,325,28444,45288602
Virginia262$4,246,86742,49963640
Minnesota344$3,883,15942,74974366

Not listed: 1 billers with an armed-forces or unknown state code (XX); they are in the national totals.

Not listed: 5 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
Los Angeles-Long Beach-Anaheim, CA331$9,792,60390,753106
New York-Newark-Jersey City, NY-NJ492$7,295,44465,23856
Chicago-Naperville-Elgin, IL-IN531$6,522,54565,64460
Seattle-Tacoma-Bellevue, WA176$4,908,24250,817105
Boston-Cambridge-Newton, MA-NH317$4,476,23744,44173
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD343$4,111,67640,26357
Houston-Pasadena-The Woodlands, TX205$3,897,21940,248118
Dallas-Fort Worth-Arlington, TX165$3,476,41335,03486
Phoenix-Mesa-Chandler, AZ128$3,435,44234,26893
Minneapolis-St. Paul-Bloomington, MN-WI276$3,310,45836,48684
Denver-Aurora-Centennial, CO177$3,203,83432,94769
Washington-Arlington-Alexandria, DC-VA-MD-WV194$3,091,58428,35863
Miami-Fort Lauderdale-West Palm Beach, FL198$2,590,78324,61964
Tampa-St. Petersburg-Clearwater, FL145$2,423,05524,82565
Atlanta-Sandy Springs-Roswell, GA126$2,193,72822,93464

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 95 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 99310 nationally

Nurse Practitioner accounts for 48% of payment for 99310 nationally in 2020, across 23 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner5,21251%$74,259,20648%816,573157
Internal Medicine1,93919%$32,806,36521%301,891156
Family Practice1,10211%$15,954,58610%150,647137
Physician Assistant6646.5%$11,425,8377.3%124,341187
Geriatric Medicine3213.1%$3,855,4502.5%35,222110
Physical Medicine and Rehabilitation1361.3%$2,505,9251.6%22,661167
Psychiatry1541.5%$2,091,9231.3%19,391126
Hospitalist1241.2%$1,739,7251.1%15,932128
Pulmonary Disease650.63%$1,526,9840.98%13,335205
General Surgery500.49%$970,6700.62%8,467169
Cardiology390.38%$960,2460.62%8,451217
General Practice630.61%$843,9010.54%7,877125
Critical Care (Intensivists)130.13%$707,0750.45%6,432495
Certified Clinical Nurse Specialist610.59%$637,2500.41%7,119117
Emergency Medicine380.37%$620,3170.40%5,831153

Not listed: 33 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 99310 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