HCPCS 99443

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

Evaluation and management Work RVU per service 1.92 (2023 fee schedule)

14,283
98th percentile among 6,405 codes billed · 2023
$59M
96th percentile among 6,405 codes billed · 2023
703K
94th percentile among 6,405 codes billed · 2023
25
52nd percentile among 6,405 codes billed · 2023
154
63rd percentile among 6,405 codes billed · 2023
-33.0%
Medicare payment on the code vs 2022; billers -34.8% · 2023

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
California2,711$15,690,896176,60729209
Massachusetts1,955$7,351,33389,09826147
New York1,198$6,826,73873,04330207
Texas742$3,147,31839,07224160
Illinois939$3,089,64535,95724118
Florida620$3,023,89935,54327160
New Jersey387$2,114,53422,94828188
Maryland319$1,388,43816,69225189
Arizona382$1,326,61517,61425110
Michigan464$1,240,42816,88123100
Pennsylvania383$1,153,34714,75624117
Washington314$877,68810,9702491
Virginia251$842,50410,43724129
Ohio379$835,95211,6932176
Connecticut185$827,5019,05422139

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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,118$7,078,85072,73030
Los Angeles-Long Beach-Anaheim, CA1,015$6,456,48072,10632
Boston-Cambridge-Newton, MA-NH1,573$5,894,62670,49426
Chicago-Naperville-Elgin, IL-IN878$2,988,86534,38524
San Francisco-Oakland-Fremont, CA398$1,726,25219,65726
Riverside-San Bernardino-Ontario, CA169$1,664,87418,57731
Washington-Arlington-Alexandria, DC-VA-MD-WV269$1,336,70514,90526
Miami-Fort Lauderdale-West Palm Beach, FL194$1,146,17913,02729
Phoenix-Mesa-Chandler, AZ255$945,63312,35526
San Diego-Chula Vista-Carlsbad, CA190$847,8099,26728
Dallas-Fort Worth-Arlington, TX197$805,7299,44523
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD186$761,7929,06425
Sacramento-Roseville-Folsom, CA154$729,8298,16424
Detroit-Warren-Dearborn, MI207$660,8278,65926
San Jose-Sunnyvale-Santa Clara, CA165$635,3636,58922

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 92 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 99443 nationally

Internal Medicine accounts for 23% of payment for 99443 nationally in 2023, across 51 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine2,59318%$13,870,72223%155,12560
Nurse Practitioner2,78219%$9,182,85216%126,47245
Family Practice1,2538.8%$5,212,9068.8%61,33249
Psychiatry7014.9%$3,878,3826.6%47,98168
Cardiology5824.1%$3,132,6395.3%33,68258
Physician Assistant8856.2%$2,369,1864.0%33,45938
Hematology-Oncology5774.0%$2,183,2033.7%25,73945
Urology4002.8%$1,473,5302.5%16,03740
Gastroenterology3692.6%$1,453,1622.5%16,51345
Pulmonary Disease3662.6%$1,346,3562.3%14,81240
Neurology3722.6%$1,335,2862.3%15,00040
Endocrinology3562.5%$1,196,5772.0%13,96739
Nephrology3522.5%$1,153,7392.0%14,47541
Anesthesiology1190.83%$970,6661.6%10,54489
Physical Medicine and Rehabilitation1451.0%$778,6331.3%8,53959

Not listed: 19 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 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