99215 is the CPT code for: Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more. In 2024, 153,625 providers billed 99215 11,827,816 times, with an estimated $1.4B paid by Medicare.
Medicare's 2026 Physician Fee Schedule national rate for 99215 is $192.39 in the office setting and $125.59 in a facility. National amounts before geographic adjustment — your locality's rate differs slightly.
What Medicare actually paid per service in 2024, on average: $120.42 (observed payment across all settings and modifiers — not a fee-schedule rate).
The top 5 billers nationally, ranked by 2024 Medicare service volume.
| # | Provider | Specialty | Location | Services | Est. Medicare paid |
|---|---|---|---|---|---|
| 1 | Stuart Hetrick, D.O. | Neurology | Phoenix, AZ | 5,220 | $634K |
| 2 | Mark Scholz, M.D. | Hematology-Oncology | Marina Del Rey, CA | 4,514 | $625K |
| 3 | Ian Purcell, MD | Neurology | San Diego, CA | 4,096 | $597K |
| 4 | Atef Rafla, M.D. | Anesthesiology | Santa Ana, CA | 4,060 | $626K |
| 5 | Jayesh Mehta, MD | Hematology | Chicago, IL | 3,534 | $511K |
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