Top billers · Codes · 99291

Who bills 99291?

99291 is the CPT code for: Critical care, first 30-74 minutes. In 2024, 73,484 providers billed 99291 5,457,118 times, with an estimated $897.2M paid by Medicare.

$308.96
2026 PFS national rate (office)
73,484
Providers billing it (2024)
5,457,118
Services billed
$897.2M
Est. Medicare paid
The fee

What does Medicare pay for 99291?

Medicare's 2026 Physician Fee Schedule national rate for 99291 is $308.96 in the office setting and $199.07 in a facility. National amounts before geographic adjustment — your locality's rate differs slightly.

Office (non-facility) rate$308.96
Facility rate$199.07
Fee schedule2026 Medicare Physician Fee Schedule

What Medicare actually paid per service in 2024, on average: $164.41 (observed payment across all settings and modifiers — not a fee-schedule rate).

The list

Who bills 99291 the most.

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

#ProviderSpecialtyLocationServicesEst. Medicare paid
1Abdulkareem Sharaf, MDCardiologyFountain Valley, CA2,536$437K
2Fred Shalom, MDCardiologyAnaheim, CA2,496$393K
3Jeffrey Banker, M.D.Clinical Cardiac ElectrophysiologyBaltimore, MD2,290$394K
4Pankaj Shah, M.D.Internal MedicineHouston, TX2,064$333K
5Alaa Afifi, MDCardiac SurgerySanta Ana, CA2,059$356K

73,479 more providers billed 99291 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 99291 gets billed.

Top states by volume

California799,568 services
Florida454,552 services
Texas410,790 services
New York382,443 services
Pennsylvania267,096 services
Illinois231,160 services
Ohio195,266 services
New Jersey186,230 services

About this code

CMS descriptionCritical care, first 30-74 minutes
Code typeCPT (Level I HCPCS)
Providers billing it (2024)73,484
Services billed (2024)5,457,118
Avg. Medicare payment per service (2024)$164.41
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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