HCPCS 99443

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

Evaluation and management Work RVU per service 0.75 (2020 fee schedule)

59,497
100th percentile among 6,116 codes billed · 2020
$207M
99th percentile among 6,116 codes billed · 2020
2.8M
98th percentile among 6,116 codes billed · 2020
27
57th percentile among 6,116 codes billed · 2020
142
64th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$100M$200M2020: $207M paid20202021: $138M paid20212022: $88M paid20222023: $59M paid20232024: $55M paid2024$55M$0$100M$200M2020: $207M paid20202021: $138M paid20212022: $88M paid20222023: $59M paid20232024: $55M paid2024$55M$0$100M$200M2020: $207M paid20202021: $138M paid20212022: $88M paid20222023: $59M paid20232024: $55M paid2024$55M$0$100M$200M2020: $207M paid20202021: $138M paid20212022: $88M paid20222023: $59M paid20232024: $55M paid2024$55M

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

Billers

025K50K2020: 59K providers20202021: 33K providers20212022: 22K providers20222023: 14K providers20232024: 12K providers202412K025K50K2020: 59K providers20202021: 33K providers20212022: 22K providers20222023: 14K providers20232024: 12K providers202412K025K50K2020: 59K providers20202021: 33K providers20212022: 22K providers20222023: 14K providers20232024: 12K providers202412K025K50K2020: 59K providers20202021: 33K providers20212022: 22K providers20222023: 14K providers20232024: 12K providers202412K

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
202412,074$54,753,774-7%618,679261631.92
202314,283$59,082,491-33%703,493251541.92
202221,912$88,125,583-36%1,059,539251511.92
202132,989$138,096,626-33%1,667,841271571.92
202059,497$207,207,145first year in data2,763,732271420.75

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
Massachusetts6,246$30,569,978392,65439198
California5,769$26,980,309325,70830183
New York3,718$12,886,306161,14425135
Illinois3,186$11,776,374150,57429139
Texas2,975$10,024,457141,40625149
Pennsylvania3,421$9,870,716131,46525112
Florida2,028$8,505,422107,06728169
Maryland1,859$7,202,58289,28929148
North Carolina2,451$6,890,03399,12925115
Ohio2,563$6,305,83293,68424105
Minnesota2,254$5,892,86480,5092596
New Jersey1,320$5,046,94659,30525130
Michigan1,628$4,950,65570,28523123
Virginia1,491$4,707,05964,91726133
Arizona1,202$4,420,49361,57729168

Not listed: 7 billers with an armed-forces or unknown state code (AE, AP, XX, ZZ); they are in the national totals.

Not listed: 2 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
Boston-Cambridge-Newton, MA-NH4,908$23,590,633303,19339
New York-Newark-Jersey City, NY-NJ2,908$11,978,516135,96826
Chicago-Naperville-Elgin, IL-IN2,777$10,881,965137,79630
Los Angeles-Long Beach-Anaheim, CA1,680$8,010,47395,73230
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,853$6,074,65578,46127
Minneapolis-St. Paul-Bloomington, MN-WI1,614$4,569,61760,87926
San Francisco-Oakland-Fremont, CA997$4,489,23851,01029
Providence-Warwick, RI-MA867$4,317,51554,19637
Baltimore-Columbia-Towson, MD1,174$4,161,72952,21227
Washington-Arlington-Alexandria, DC-VA-MD-WV930$3,740,87443,98228
Phoenix-Mesa-Chandler, AZ746$2,711,52436,42727
Miami-Fort Lauderdale-West Palm Beach, FL615$2,691,27732,86327
Dallas-Fort Worth-Arlington, TX828$2,583,60937,42125
Detroit-Warren-Dearborn, MI733$2,537,36334,40624
San Diego-Chula Vista-Carlsbad, CA706$2,406,17129,98629

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 2020.

Specialties billing 99443 nationally

Internal Medicine accounts for 23% of payment for 99443 nationally in 2020, across 62 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine11,70420%$47,177,01923%612,60152
Family Practice8,16814%$24,965,68812%334,24641
Nurse Practitioner8,91815%$24,069,74312%374,89442
Cardiology3,9456.6%$17,210,9528.3%217,72055
Psychiatry2,0953.5%$10,275,8555.0%136,19365
Endocrinology2,0763.5%$9,292,3784.5%117,68557
Nephrology2,0183.4%$8,151,6133.9%102,23451
Neurology2,5254.2%$7,549,4953.6%98,46939
Physician Assistant2,8184.7%$6,597,9223.2%103,19337
Pulmonary Disease1,7743.0%$6,317,1023.0%79,52245
Gastroenterology2,0443.4%$5,824,6602.8%73,15136
Hematology-Oncology1,5492.6%$5,574,9772.7%73,06347
Rheumatology1,2482.1%$4,631,9272.2%59,79348
Interventional Cardiology7341.2%$2,984,5421.4%37,72351
Urology8211.4%$2,908,5671.4%35,65043

Not listed: 12 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 99443 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