Top billers · Codes · 99214

Who bills 99214?

99214 is the CPT code for: Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more. In 2024, 498,045 providers billed 99214 102,377,857 times, with an estimated $8.4B paid by Medicare.

$135.61
2026 PFS national rate (office)
498,045
Providers billing it (2024)
102,377,857
Services billed
$8.4B
Est. Medicare paid
The fee

What does Medicare pay for 99214?

Medicare's 2026 Physician Fee Schedule national rate for 99214 is $135.61 in the office setting and $84.50 in a facility. National amounts before geographic adjustment — your locality's rate differs slightly.

Office (non-facility) rate$135.61
Facility rate$84.50
Fee schedule2026 Medicare Physician Fee Schedule

What Medicare actually paid per service in 2024, on average: $82.34 (observed payment across all settings and modifiers — not a fee-schedule rate).

The list

Who bills 99214 the most.

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

#ProviderSpecialtyLocationServicesEst. Medicare paid
1Salar Deldar, M.D.Pain ManagementMonterey, CA15,268$1.2M
2Qi Cao, MDInternal MedicineBaltimore, MD8,734$852K
3Florian Gegaj, M.D.Internal MedicineThe Villages, FL7,961$698K
4Antonio VillalvazoFamily PracticeFresno, CA7,059$717K
5Pete Coury, MDFamily PracticeMesa, AZ6,894$606K

498,040 more providers billed 99214 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.

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The breakdown

Where 99214 gets billed.

Top states by volume

California10,010,320 services
Florida9,649,855 services
Texas7,267,461 services
New York6,175,119 services
Pennsylvania4,268,181 services
Illinois3,817,561 services
New Jersey3,601,814 services
North Carolina3,505,738 services

About this code

CMS descriptionEstablished patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
Code typeCPT (Level I HCPCS)
Providers billing it (2024)498,045
Services billed (2024)102,377,857
Avg. Medicare payment per service (2024)$82.34
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.

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