Top billers · Codes · 99211

Who bills 99211?

99211 is the CPT code for: Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional. In 2024, 13,851 providers billed 99211 962,003 times, with an estimated $15.4M paid by Medicare.

$24.38
2026 PFS national rate (office)
13,851
Providers billing it (2024)
962,003
Services billed
$15.4M
Est. Medicare paid
The fee

What does Medicare pay for 99211?

Medicare's 2026 Physician Fee Schedule national rate for 99211 is $24.38 in the office setting and $7.68 in a facility. National amounts before geographic adjustment — your locality's rate differs slightly.

Office (non-facility) rate$24.38
Facility rate$7.68
Fee schedule2026 Medicare Physician Fee Schedule

What Medicare actually paid per service in 2024, on average: $16.05 (observed payment across all settings and modifiers — not a fee-schedule rate).

The list

Who bills 99211 the most.

The top 5 billers nationally, ranked by 2024 Medicare service volume.

#ProviderSpecialtyLocationServicesEst. Medicare paid
1Bryan Doonan, MDFamily PracticeNewport Beach, CA17,523$320K
2Maurice Levy, MDGeneral PracticeLos Angeles, CA9,953$200K
3Mehbub Kapadia, M.D.Internal MedicineChicago, IL5,144$74K
4Rachel SaenzNurse PractitionerPahrump, NV3,867$58K
5Rostam Khoshsar, MDPain ManagementLawndale, CA2,715$55K

13,846 more providers billed 99211 in 2024. The full ranked list — filtered to your exact territory, with phone numbers and year-over-year history — is one search in Prospect 811.

See the full list
The breakdown

Where 99211 gets billed.

Top states by volume

California165,841 services
Florida112,389 services
Arizona46,632 services
Texas44,574 services
New York36,553 services
North Carolina35,589 services
Illinois34,391 services
Georgia28,590 services

About this code

CMS descriptionOffice or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
Code typeCPT (Level I HCPCS)
Providers billing it (2024)13,851
Services billed (2024)962,003
Avg. Medicare payment per service (2024)$16.05
Where these numbers come from. Rates are CMS's own public fee-schedule files — the Physician Fee Schedule, Clinical Laboratory Fee Schedule, ASP drug pricing, DMEPOS, and the OPPS/ASC addenda — each labeled with its file year on this page; national amounts are shown before geographic adjustment. Codes with no separate rate render the fee schedule's own status in words, never a fake $0. Utilization comes from CMS's public Medicare Provider Utilization & Payment data for 2024, the most recent year released. It covers traditional Medicare fee-for-service only (no commercial insurance, no Medicare Advantage), and CMS suppresses any provider-and-code line with fewer than 11 beneficiaries before publishing, so low-volume billers don't appear at all. "Est. Medicare paid" is each billing line's average Medicare payment times its service count, summed — actual per-claim payment varies by setting and modifiers. For drug and supply codes, a "service" is a billed unit (a milligram, a milliliter, a square centimeter), not a patient visit. Code descriptions are CMS's own, from the utilization files. Prospect 811 organizes public data; it doesn't add to or alter it. Not affiliated with or endorsed by CMS. Full detail on the data page.

One code, one year, top 5. The app has all of it.

Prospect 811 answers "what is this code, what does it pay, and who bills it?" for every billable code — then filters the answer to your exact territory, with phone numbers. $79/month, no contract, 14-day refund.

Start prospecting
Sign in with Google or a magic link · or grab the free DIY guide first.