HCPCS 99310

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

Evaluation and management Work RVU per service 2.80 (2023 fee schedule)

12,486
98th percentile among 6,405 codes billed · 2023
$205M
99th percentile among 6,405 codes billed · 2023
1.9M
97th percentile among 6,405 codes billed · 2023
69
80th percentile among 6,405 codes billed · 2023
537
80th percentile among 6,405 codes billed · 2023
+19.8%
Medicare payment on the code vs 2022; billers +12.3% · 2023

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
California838$26,137,975216,798891,104
Florida955$18,365,418168,35980584
Texas855$16,223,404154,85282714
Pennsylvania781$10,771,493101,59160490
New Jersey567$10,070,54686,30368561
Illinois624$9,334,10785,12967447
Massachusetts511$7,856,70371,92276460
Maryland383$7,359,80664,45477614
New York582$7,347,72462,90848398
Virginia389$5,504,14851,19967393
Colorado255$5,497,43551,22493707
Arizona240$5,435,32950,11683689
North Carolina474$4,974,51549,47154373
Washington259$4,770,91344,48482716
South Carolina274$4,707,42547,53082613

Not listed: 4 billers with an armed-forces or unknown state code (AE, AP, XX); 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 2023.

Top metro areas

observed calculated calculated calculated calculated
Los Angeles-Long Beach-Anaheim, CA370$12,283,044101,55594
New York-Newark-Jersey City, NY-NJ656$10,934,68089,87655
Chicago-Naperville-Elgin, IL-IN534$8,065,24872,90867
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD497$7,461,43467,48871
Boston-Cambridge-Newton, MA-NH336$5,515,28750,75280
Washington-Arlington-Alexandria, DC-VA-MD-WV272$5,037,71743,28378
Denver-Aurora-Centennial, CO203$4,668,41643,21497
Houston-Pasadena-The Woodlands, TX204$4,362,75541,29989
Baltimore-Columbia-Towson, MD205$4,102,67836,35485
Miami-Fort Lauderdale-West Palm Beach, FL230$3,523,54130,89073
Riverside-San Bernardino-Ontario, CA62$3,475,54829,041114
Seattle-Tacoma-Bellevue, WA164$3,356,51230,97795
Tampa-St. Petersburg-Clearwater, FL175$3,329,07030,76181
Phoenix-Mesa-Chandler, AZ161$3,272,30830,48880
Minneapolis-St. Paul-Bloomington, MN-WI260$3,214,33932,08874

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 2023.

Specialties billing 99310 nationally

Nurse Practitioner accounts for 53% of payment for 99310 nationally in 2023, across 20 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner7,13257%$108,016,60353%1,075,516151
Internal Medicine1,90315%$36,447,19818%301,698159
Family Practice1,1339.1%$18,041,4168.8%152,955135
Physician Assistant9007.2%$14,908,3627.3%146,936163
Geriatric Medicine3182.5%$4,333,6652.1%35,182111
Hospitalist1701.4%$2,911,3271.4%24,455144
Pulmonary Disease810.65%$2,530,7661.2%20,033247
Physical Medicine and Rehabilitation1571.3%$2,476,1131.2%19,949127
General Surgery710.57%$2,399,5741.2%18,966267
General Practice720.58%$1,612,3520.79%13,489187
Psychiatry1180.95%$1,530,0800.75%12,723108
Infectious Disease450.36%$1,363,2090.67%10,843241
Emergency Medicine600.48%$1,024,9620.50%8,749146
Cardiology280.22%$662,6280.32%5,108182
Critical Care (Intensivists)150.12%$637,2020.31%4,949330

Not listed: 36 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 2023.

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