HCPCS 99457
Evaluation and management service (ClaimLight category; the code descriptor is not shown)
Evaluation and management Work RVU per service 0.61 (2024 fee schedule)
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 | 6,982 | $93,814,831 | +30% | 2,500,830 | 146 | 1,200 | 0.61 |
| 2023 | 6,044 | $72,037,095 | +28% | 1,913,465 | 142 | 1,092 | 0.61 |
| 2022 | 4,602 | $56,203,168 | +58% | 1,438,115 | 137 | 1,147 | 0.61 |
| 2021 | 3,232 | $35,468,942 | +152% | 874,073 | 124 | 960 | 0.61 |
| 2020 | 1,683 | $14,090,241 | first year in data | 345,395 | 91 | 706 | 0.61 |
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 | 921 | $20,528,952 | 514,251 | 242 | 2,202 | |
| Texas | 741 | $9,570,836 | 261,123 | 146 | 1,017 | |
| Florida | 512 | $9,128,554 | 245,145 | 141 | 1,526 | |
| New York | 564 | $7,993,873 | 199,018 | 163 | 1,011 | |
| Connecticut | 41 | $4,259,412 | 108,958 | 196 | 4,290 | |
| New Jersey | 383 | $4,220,972 | 103,618 | 150 | 762 | |
| Georgia | 347 | $4,124,278 | 118,454 | 168 | 1,103 | |
| Virginia | 244 | $3,685,794 | 99,743 | 178 | 1,468 | |
| Arizona | 313 | $3,216,486 | 89,459 | 139 | 1,001 | |
| Illinois | 243 | $2,560,435 | 66,644 | 113 | 845 | |
| Maryland | 173 | $2,295,215 | 58,818 | 136 | 1,276 | |
| Tennessee | 172 | $2,092,110 | 61,568 | 127 | 1,250 | |
| Michigan | 170 | $1,797,955 | 47,871 | 116 | 647 | |
| South Carolina | 186 | $1,440,069 | 41,447 | 152 | 566 | |
| Missouri | 60 | $1,386,628 | 38,385 | 141 | 1,388 |
Not listed: 8 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 2024.
Top metro areas
| observed | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|
| New York-Newark-Jersey City, NY-NJ | 756 | $10,215,625 | 250,322 | 152 | |
| Los Angeles-Long Beach-Anaheim, CA | 454 | $9,660,942 | 233,583 | 258 | |
| Bridgeport-Stamford-Danbury, CT | 17 | $3,870,858 | 98,859 | 214 | |
| Dallas-Fort Worth-Arlington, TX | 238 | $3,781,151 | 102,014 | 127 | |
| Miami-Fort Lauderdale-West Palm Beach, FL | 135 | $3,023,241 | 77,797 | 183 | |
| Houston-Pasadena-The Woodlands, TX | 220 | $2,714,320 | 73,402 | 167 | |
| Chicago-Naperville-Elgin, IL-IN | 223 | $2,499,893 | 65,210 | 111 | |
| Washington-Arlington-Alexandria, DC-VA-MD-WV | 215 | $2,469,157 | 62,414 | 132 | |
| Richmond, VA | 107 | $2,452,586 | 65,924 | 307 | |
| Phoenix-Mesa-Chandler, AZ | 191 | $2,252,598 | 61,724 | 169 | |
| North Port-Bradenton-Sarasota, FL | 18 | $2,077,449 | 57,143 | 262 | |
| Riverside-San Bernardino-Ontario, CA | 84 | $1,901,896 | 61,284 | 302 | |
| San Diego-Chula Vista-Carlsbad, CA | 80 | $1,777,470 | 43,981 | 302 | |
| San Francisco-Oakland-Fremont, CA | 40 | $1,718,212 | 39,238 | 429 | |
| Atlanta-Sandy Springs-Roswell, GA | 149 | $1,487,237 | 40,878 | 137 |
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 87 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2024.
Specialties billing 99457 nationally
Internal Medicine accounts for 26% of payment for 99457 nationally in 2024, across 26 specialties on claims.
| observed | calculated | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|---|
| Internal Medicine | 1,856 | 27% | $24,143,075 | 26% | 629,128 | 339 |
| Cardiology | 882 | 13% | $22,980,531 | 24% | 606,393 | 688 |
| Family Practice | 1,429 | 20% | $14,494,924 | 15% | 390,363 | 273 |
| Nephrology | 556 | 8.0% | $7,059,160 | 7.5% | 189,237 | 340 |
| Nurse Practitioner | 855 | 12% | $4,727,094 | 5.0% | 148,594 | 174 |
| Geriatric Medicine | 20 | 0.29% | $3,496,045 | 3.7% | 90,331 | 4,517 |
| Interventional Cardiology | 222 | 3.2% | $3,472,119 | 3.7% | 91,005 | 410 |
| Pulmonary Disease | 173 | 2.5% | $2,107,385 | 2.2% | 55,824 | 323 |
| Emergency Medicine | 54 | 0.77% | $2,018,733 | 2.2% | 51,486 | 953 |
| Endocrinology | 105 | 1.5% | $1,287,880 | 1.4% | 32,633 | 311 |
| Clinical Cardiac Electrophysiology | 86 | 1.2% | $1,113,153 | 1.2% | 30,889 | 359 |
| General Practice | 74 | 1.1% | $1,052,207 | 1.1% | 27,268 | 368 |
| Physician Assistant | 175 | 2.5% | $788,684 | 0.84% | 24,749 | 141 |
| Gastroenterology | 94 | 1.3% | $446,089 | 0.48% | 11,941 | 127 |
| Sleep Medicine | 22 | 0.32% | $408,542 | 0.44% | 11,206 | 509 |
Not listed: 31 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 2024.
Top billers of 99457 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