Top billers · Codes · 99350

Who bills 99350?

99350 is the CPT code for: Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes. In 2024, 7,440 providers billed 99350 1,238,110 times, with an estimated $152.0M paid by Medicare.

$193.06
2026 PFS national rate (office)
7,440
Providers billing it (2024)
1,238,110
Services billed
$152.0M
Est. Medicare paid
The fee

What does Medicare pay for 99350?

Medicare's 2026 Physician Fee Schedule national rate for 99350 is $193.06 in the office setting. National amounts before geographic adjustment — your locality's rate differs slightly.

Office (non-facility) rate$193.06
Facility rateNo separate facility rate
Fee schedule2026 Medicare Physician Fee Schedule

What Medicare actually paid per service in 2024, on average: $122.76 (observed payment across all settings and modifiers — not a fee-schedule rate).

The list

Who bills 99350 the most.

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

#ProviderSpecialtyLocationServicesEst. Medicare paid
1Nelson Dalla Tor, MDFamily PracticeWhittier, CA9,617$1.4M
2Harry Lazarte, M.D.Internal MedicineScottsbluff, NE6,967$919K
3Maria Ortiz, M.D.Family PracticeSan Fernando, CA6,506$895K
4Andro Sharobiem, M.D.Internal MedicineRiverside, CA6,352$920K
5Heather Cooksey, FNPNurse PractitionerRiverside, CA5,324$673K

7,435 more providers billed 99350 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 99350 gets billed.

Top states by volume

Florida213,895 services
California184,308 services
Texas154,202 services
New Jersey50,695 services
Illinois46,535 services
New York46,171 services
North Carolina41,629 services
Maryland40,617 services

About this code

CMS descriptionResidence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes
Code typeCPT (Level I HCPCS)
Providers billing it (2024)7,440
Services billed (2024)1,238,110
Avg. Medicare payment per service (2024)$122.76
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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