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Market snapshot

99214 in MA CY2024

Medicare Part B FFS · CY2024 · as published by CMS

99214 — Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more

Billing groups
1,221
Named-group FFS services
2,052,716
FFS of Medicare
64%
Services YoY
+3.5%
FFS enrollment -1.4%
Estimated all-Medicare volume FFS + estimated MA estimate
~3,179,661 services

2,052,716 observed fee-for-service (65%) · ~1,126,945 estimated Medicare Advantage. Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale

Named-group submitted charges
$748.2M
Named-group allowed amount
$241.7M
Named-group Medicare payments
$170.0M
Avg charge / svc
$364
Avg allowed / svc
$118
Avg payment / svc
$83
Average charge per group
$94 1,221 groups · avg submitted charge / service $2,000
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Specialty market — Cardiovascular Disease (Cardiology): 24,292 services across 23 groups; top group 18%. See Cardiovascular Disease (Cardiology) across all states →

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 99214 services, CY2024
#Physician group City Specialty Providers 99214 svcs Submitted charges Avg charge Medicare $ locked column Share of specialty*Share of state* Phone
1 LGH MERRIMACK VALLEY CARDIOLOGY ASSOCIATES, LLC NORTH CHELMSFORD CARDIOVASCULAR DISEASE (CARDIOLOGY) 22 4,427 $1,584,866 $358 premium 18.2% 0.2% (978) 256-6607
2 CARDIOVASCULAR CONSULTANTS OF CAPE COD LLC HYANNIS CARDIOVASCULAR DISEASE (CARDIOLOGY) 4 3,520 $1,214,400 $345 premium 14.5% 0.1% (508) 778-8818
3 SOUTHCOAST CARDIOLOGY LLC NEW BEDFORD CARDIOVASCULAR DISEASE (CARDIOLOGY) 2 1,950 $661,050 $339 premium 8.0% 0.1% (774) 992-7499
4 HEART CENTER OF METROWEST, INC. FRAMINGHAM CARDIOVASCULAR DISEASE (CARDIOLOGY) 17 1,822 $694,310 $381 premium 7.5% 0.1% (508) 875-4811
5 READING CARDIOLOGY ASSOCIATES P.C. NORTH READING CARDIOVASCULAR DISEASE (CARDIOLOGY) 4 1,777 $541,985 $305 premium 7.3% 0.1% (978) 664-4600
6 CARDIOVASCULAR CENTER AT TUFTS MEDICAL CENTER INC BOSTON CARDIOVASCULAR DISEASE (CARDIOLOGY) 94 1,630 $618,745 $380 premium 6.7% 0.1% (617) 636-5000
7 HAMPDEN AND FRANKLIN COUNTY CARDIOVASCULAR ASSOCIATES PC SPRINGFIELD CARDIOVASCULAR DISEASE (CARDIOLOGY) 20 1,481 $566,255 $382 premium 6.1% 0.1% 4137486484202
8 MELROSE INTERNAL MEDICINE ASSOC PC MELROSE CARDIOVASCULAR DISEASE (CARDIOLOGY) 7 1,365 $486,800 $357 premium 5.6% 0.0% (781) 979-3800
9 LOWN MEDICAL GROUP PLLC CHESTNUT HILL CARDIOVASCULAR DISEASE (CARDIOLOGY) 12 1,332 $534,711 $401 premium 5.5% 0.0% (617) 732-1318
10 RILEY YORK CARDIOLOGY ASSOCIATES INC WELLESLEY CARDIOVASCULAR DISEASE (CARDIOLOGY) 2 1,276 $435,162 $341 premium 5.3% 0.0% (617) 431-3237
11 HUDSON VALLEY CARDIOVASCULAR PRACTICE PC POUGHKEEPSIE CARDIOVASCULAR DISEASE (CARDIOLOGY) 72 678 $188,778 $278 premium 2.8% 0.0% (845) 473-1188
12 BON SECOURS ST MARYS HOSPITAL OF RICHMOND LLC RICHMOND CARDIOVASCULAR DISEASE (CARDIOLOGY) 67 545 $175,593 $322 premium 2.2% 0.0% (804) 288-3123
13 LIFESPAN OF MASSACHUSETTS - FALL RIVER INC FALL RIVER CARDIOVASCULAR DISEASE (CARDIOLOGY) 24 495 $113,282 $229 premium 2.0% 0.0% (508) 674-5600
14 ARETAEUS TELEMEDICINE INC WILLITS CARDIOVASCULAR DISEASE (CARDIOLOGY) 19 446 $76,712 $172 premium 1.8% 0.0% (707) 459-6801
15 MAYFLOWER MEDICAL ASSOCIATES PC PLYMOUTH CARDIOVASCULAR DISEASE (CARDIOLOGY) 2 407 $125,350 $308 premium 1.7% 0.0% (508) 746-1326
16 CARDIOVASCULAR ASSOCIATES OF THE DELAWARE VALLEY,P A HADDON HEIGHTS CARDIOVASCULAR DISEASE (CARDIOLOGY) 94 312 $77,628 $249 premium 1.3% 0.0% (856) 546-3003
17 TOTAL HEALTH CARE, PC MILTON CARDIOVASCULAR DISEASE (CARDIOLOGY) 2 246 $56,580 $230 premium 1.0% 0.0% (617) 698-0715
18 CONSULTING CARDIOLOGISTS PC HARTFORD CARDIOVASCULAR DISEASE (CARDIOLOGY) 24 216 $54,000 $250 premium 0.9% 0.0% (860) 522-0604
19 THE HEART MEDICAL GROUP VAN NUYS CARDIOVASCULAR DISEASE (CARDIOLOGY) 8 114 $25,728 $226 premium 0.5% 0.0% (818) 904-6782
20 MACRO, INC. CAMBRIDGE CARDIOVASCULAR DISEASE (CARDIOLOGY) 10 105 $31,500 $300 premium 0.4% 0.0% (671) 499-5005
21 ST. JOSEPH'S CARDIOLOGY GROUP LLC SAVANNAH CARDIOVASCULAR DISEASE (CARDIOLOGY) 17 84 $26,368 $314 premium 0.3% 0.0% (912) 927-3434
22 CARDIOVASCULAR SPECIALISTS OF NEW ENGLAND, LLC LONDONDERRY CARDIOVASCULAR DISEASE (CARDIOLOGY) 14 47 $7,101 $151 premium 0.2% 0.0% (603) 323-0883
23 PROFESSIONAL SERVICE FUND OF DEBORAH HEART AND LUNG CENTER BROWNS MILLS CARDIOVASCULAR DISEASE (CARDIOLOGY) 121 17 $4,913 $289 premium 0.1% 0.0% (609) 893-6611

*"Share of specialty" is the group's share of disclosed Medicare-FFS services for the primary code among groups with the SAME modal specialty in the state; "share of state" is the same figure against the whole state. Specialty is each group's modal member specialty from CMS's clinician register — a multi-specialty group carries one label. Where fewer than 11 groups share the specialty in the state, the specialty share renders "—" — the specialty benchmark is suppressed (fewer than 11 groups) and the state share alongside is the benchmark. Group figures sum clinicians affiliated with exactly one group. See Methods.

Comparing against an all-payer estimate?

These are exact counts from Medicare fee-for-service claims — roughly a third to half of most procedure markets, depending on payer mix. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →