HCPCS 99454
Evaluation and management service (ClaimLight category; the code descriptor is not shown)
Evaluation and management Work RVU per service none (2023 fee schedule; adds 0 work RVUs)
Trend
Medicare payment on the code
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.
Billers
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 | |
|---|---|---|---|---|---|---|---|
| 2024 | 6,419 | $74,901,155 | +17% | 2,027,677 | 146 | 1,071 | 0.00 |
| 2023 | 5,663 | $64,021,548 | +14% | 1,640,798 | 134 | 1,013 | 0.00 |
| 2022 | 4,305 | $55,948,412 | +23% | 1,274,365 | 135 | 1,052 | 0.00 |
| 2021 | 3,063 | $45,488,190 | +123% | 903,328 | 137 | 1,031 | 0.00 |
| 2020 | 1,601 | $20,364,405 | first year in data | 408,147 | 104 | 958 | 0.00 |
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 | |
|---|---|---|---|---|---|---|
| California | 720 | $14,527,570 | 324,985 | 216 | 1,618 | |
| Texas | 676 | $6,085,299 | 167,198 | 127 | 853 | |
| Florida | 416 | $5,659,441 | 153,971 | 167 | 1,143 | |
| New York | 418 | $5,210,083 | 118,890 | 131 | 884 | |
| New Jersey | 303 | $3,432,368 | 77,596 | 138 | 940 | |
| Georgia | 268 | $2,985,969 | 86,473 | 163 | 1,084 | |
| Virginia | 207 | $2,807,023 | 73,814 | 221 | 1,145 | |
| Maryland | 230 | $2,684,802 | 65,822 | 147 | 949 | |
| Arizona | 208 | $2,639,526 | 73,118 | 110 | 1,211 | |
| Illinois | 149 | $1,612,017 | 41,220 | 132 | 877 | |
| Tennessee | 143 | $1,283,401 | 37,603 | 109 | 783 | |
| Pennsylvania | 146 | $1,248,183 | 31,279 | 103 | 492 | |
| Connecticut | 35 | $1,186,137 | 27,872 | 193 | 2,576 | |
| North Carolina | 131 | $978,368 | 27,921 | 105 | 644 | |
| Nevada | 85 | $877,530 | 23,122 | 141 | 1,104 |
Not listed: 10 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-NJ | 584 | $7,103,901 | 158,424 | 141 | |
| Los Angeles-Long Beach-Anaheim, CA | 359 | $6,978,297 | 154,672 | 221 | |
| Washington-Arlington-Alexandria, DC-VA-MD-WV | 212 | $2,409,539 | 56,078 | 153 | |
| Phoenix-Mesa-Chandler, AZ | 138 | $2,282,169 | 62,931 | 139 | |
| Richmond, VA | 90 | $1,849,662 | 48,842 | 345 | |
| Houston-Pasadena-The Woodlands, TX | 192 | $1,785,231 | 47,365 | 141 | |
| Dallas-Fort Worth-Arlington, TX | 206 | $1,764,604 | 48,324 | 119 | |
| Chicago-Naperville-Elgin, IL-IN | 147 | $1,632,447 | 42,069 | 134 | |
| Miami-Fort Lauderdale-West Palm Beach, FL | 105 | $1,316,137 | 34,347 | 197 | |
| Philadelphia-Camden-Wilmington, PA-NJ-DE-MD | 93 | $1,254,756 | 30,415 | 125 | |
| San Francisco-Oakland-Fremont, CA | 39 | $1,194,364 | 23,452 | 298 | |
| San Diego-Chula Vista-Carlsbad, CA | 59 | $1,183,895 | 26,841 | 230 | |
| Atlanta-Sandy Springs-Roswell, GA | 105 | $1,144,823 | 30,251 | 138 | |
| North Port-Bradenton-Sarasota, FL | 24 | $1,066,353 | 29,244 | 256 | |
| Riverside-San Bernardino-Ontario, CA | 61 | $867,087 | 20,660 | 173 |
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 75 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 99454 nationally
Internal Medicine accounts for 27% of payment for 99454 nationally in 2023, across 25 specialties on claims.
| observed | calculated | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|---|
| Internal Medicine | 1,584 | 28% | $17,176,412 | 27% | 428,972 | 271 |
| Cardiology | 719 | 13% | $15,770,119 | 25% | 391,253 | 544 |
| Family Practice | 1,232 | 22% | $10,681,337 | 17% | 278,562 | 226 |
| Nephrology | 362 | 6.4% | $3,850,991 | 6.0% | 100,782 | 278 |
| Nurse Practitioner | 586 | 10% | $3,700,748 | 5.8% | 112,859 | 193 |
| Interventional Cardiology | 158 | 2.8% | $2,631,496 | 4.1% | 68,433 | 433 |
| Pulmonary Disease | 166 | 2.9% | $1,688,177 | 2.6% | 43,007 | 259 |
| Clinical Cardiac Electrophysiology | 59 | 1.0% | $1,201,705 | 1.9% | 30,659 | 520 |
| Endocrinology | 74 | 1.3% | $960,892 | 1.5% | 23,479 | 317 |
| Sleep Medicine | 20 | 0.35% | $875,611 | 1.4% | 22,110 | 1,106 |
| General Practice | 55 | 0.97% | $805,451 | 1.3% | 19,316 | 351 |
| Geriatric Medicine | 19 | 0.34% | $795,278 | 1.2% | 18,128 | 954 |
| Gastroenterology | 147 | 2.6% | $514,896 | 0.80% | 14,482 | 99 |
| Emergency Medicine | 37 | 0.65% | $490,069 | 0.77% | 12,509 | 338 |
| Physician Assistant | 123 | 2.2% | $477,576 | 0.75% | 14,643 | 119 |
Not listed: 29 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 99454 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