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Market snapshot

99214 in WI 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
622
Named-group FFS services
917,482
FFS of Medicare
42%
Services YoY
+1.8%
FFS enrollment -2.9%
Estimated all-Medicare volume FFS + estimated MA estimate
~2,129,294 services

917,482 observed fee-for-service (43%) · ~1,211,812 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
$317.8M
Named-group allowed amount
$98.2M
Named-group Medicare payments
$66.4M
Avg charge / svc
$346
Avg allowed / svc
$107
Avg payment / svc
$72
Average charge per group
$88 622 groups · avg submitted charge / service $1,222
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Specialty market — Family Practice: 48,738 services across 47 groups; top group 47%. See Family Practice across all states →

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
#Physician group City Specialty Providers 99214 svcs Submitted charges Avg charge Medicare $ Share of specialty*Share of state* Phone
1 MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION INC LA CROSSE FAMILY PRACTICE 547 22,815 $4,967,284 $218 46.8% 1.8% (608) 785-0940
2 HUDSON PHYSICIANS SC HUDSON FAMILY PRACTICE 61 5,916 $2,044,640 $346 12.1% 0.5% (715) 531-6800
3 PRIMARY CARE ASSOCIATES OF APPLETON, LTD APPLETON FAMILY PRACTICE 31 4,800 $1,889,516 $394 9.8% 0.4% (920) 996-1000
4 INDEPENDENT PHYSICIANS OF WISCONSIN LLC MILWAUKEE FAMILY PRACTICE 41 1,991 $604,841 $304 4.1% 0.2% (414) 875-0505
5 WILDWOOD FAMILY CLINIC SC MADISON FAMILY PRACTICE 27 1,734 $601,698 $347 3.6% 0.1% (608) 221-1501
6 WATERTOWN FAMILY PRACTICE ASSOCIATES, SC WATERTOWN FAMILY PRACTICE 11 1,696 $644,750 $380 3.5% 0.1% (920) 261-8500
7 FAIRVIEW CLINICS EAGAN FAMILY PRACTICE 816 1,605 $788,347 $491 3.3% 0.1% (651) 406-8860
8 REGENTS OF THE UNIVERSITY OF CALIFORNIA SACRAMENTO FAMILY PRACTICE 561 710 $356,420 $502 1.5% 0.1% (916) 734-7777
9 ST. CROIX REGIONAL MEDICAL CENTER SAINT CROIX FALLS FAMILY PRACTICE 133 545 $137,340 $252 1.1% 0.0% (715) 483-3221
10 PONDEROSA FAMILY PHYSICIANS PC AURORA FAMILY PRACTICE 8 545 $76,406 $140 1.1% 0.0% (303) 690-4891
11 TRENTON TOTAL HEALTH CARE CENTER PC TRENTON FAMILY PRACTICE 2 526 $77,409 $147 1.1% 0.0% (734) 676-8530
12 KAUKAUNA CLINIC, S.C. KAUKAUNA FAMILY PRACTICE 8 525 $185,472 $353 1.1% 0.0% (920) 766-4656
13 MOSAIC FAMILY HEALTH INC APPLETON FAMILY PRACTICE 14 483 $154,560 $320 1.0% 0.0% (920) 832-2783
14 HEALTH SERVICE SYSTEMS, INC NEW LENOX FAMILY PRACTICE 60 472 $115,390 $244 1.0% 0.0% (815) 727-4292
15 BANNER HEALTH PHYSICIANS WEST LLC CASPER FAMILY PRACTICE 97 383 $96,563 $252 0.8% 0.0% —
16 MENOMINEE INDIAN TRIBE OF WISCONSIN KESHENA FAMILY PRACTICE 24 364 $76,252 $209 0.7% 0.0% —
17 MAINSTREET CLINIC SC ASHLAND FAMILY PRACTICE 2 352 $99,255 $282 0.7% 0.0% (715) 682-5601
18 FAMILY CARE OF THE FOX CITIES SC APPLETON FAMILY PRACTICE 5 311 $118,149 $380 0.6% 0.0% (920) 730-2747
19 PRESBYTERIAN HOMES OF WISCONSIN INC WAUKESHA FAMILY PRACTICE 37 301 $155,015 $515 0.6% 0.0% (651) 631-6570
20 HONORHEALTH MEDICAL GROUP, LLC PHOENIX FAMILY PRACTICE 326 293 $70,698 $241 0.6% 0.0% (602) 371-3100
21 ANN M MASS MD PC ASPEN FAMILY PRACTICE 3 196 $68,136 $348 0.4% 0.0% (970) 544-1234
22 VALLEY MEDICAL GROUP-RENTON RENTON FAMILY PRACTICE 440 192 $51,120 $266 0.4% 0.0% (425) 656-4224
23 PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC DES PLAINES FAMILY PRACTICE 262 177 $40,710 $230 0.4% 0.0% (847) 297-1800
24 GRANT REGIONAL HEALTH CENTER INC LANCASTER FAMILY PRACTICE 34 174 $44,370 $255 0.4% 0.0% (608) 723-2131
25 PROVIDENCE HEALTH AND SERVICES WASHINGTON OLYMPIA FAMILY PRACTICE 477 163 $63,733 $391 0.3% 0.0% (360) 493-4083
26 ACCESS COMMUNITY HEALTH CENTERS INC MADISON FAMILY PRACTICE 68 135 $46,611 $345 0.3% 0.0% (608) 263-3111
27 IRONWOOD FAMILY PRACTICE, PA COEUR D ALENE FAMILY PRACTICE 13 127 $32,196 $254 0.3% 0.0% (208) 667-4557
28 DOUSMAN CLINIC, S.C. GREEN BAY FAMILY PRACTICE 3 120 $26,880 $224 0.2% 0.0% 9204949661185
29 MEDICAL ASSOCIATES PROFESSIONAL SERVICES, LLC CANTON FAMILY PRACTICE 27 111 $23,362 $210 0.2% 0.0% (770) 479-5535
30 PROGRESSIVE BEGINNINGS, LLC SHEBOYGAN FAMILY PRACTICE 19 106 $54,590 $515 0.2% 0.0% (920) 803-1617
31 HEARTLAND PRIMARY CARE S C BOLINGBROOK FAMILY PRACTICE 2 89 $12,905 $145 0.2% 0.0% (630) 378-4880
32 YAKAMA INDIAN HEALTH CENTER TOPPENISH FAMILY PRACTICE 10 81 $23,409 $289 0.2% 0.0% (509) 865-1705
33 FAYETTEVILLE AREA HEALTH EDUCATION FOUNDATION INC FAYETTEVILLE FAMILY PRACTICE 27 80 $20,000 $250 0.2% 0.0% (910) 678-0100
34 WINNESHIEK MEDICAL CENTER DECORAH FAMILY PRACTICE 98 76 $19,648 $259 0.2% 0.0% (563) 382-2911
35 16TH STREET COMMUNITY HEALTH CENTER INC. MILWAUKEE FAMILY PRACTICE 86 73 $22,481 $308 0.1% 0.0% (414) 672-1353
36 PROGRESSIVE MEDICAL GROUP INC MILWAUKEE FAMILY PRACTICE 2 68 $23,800 $350 0.1% 0.0% (414) 251-3500
37 VERNON MEMORIAL HEALTHCARE INC VIROQUA FAMILY PRACTICE 72 68 $19,152 $282 0.1% 0.0% (608) 637-2101
38 DULUTH GRADUATE MEDICAL EDUCATION COUNCIL INC DULUTH FAMILY PRACTICE 32 68 $20,920 $308 0.1% 0.0% (218) 723-1112
39 ST GIANNA MOLLA CLINIC, INC DE PERE FAMILY PRACTICE 6 61 $22,372 $367 0.1% 0.0% (920) 605-3115
40 OUTREACH COMMUNITY HEALTH CENTERS INC MILWAUKEE FAMILY PRACTICE 55 41 $15,006 $366 0.1% 0.0% (414) 727-6320
41 INTERCARE COMMUNITY HEALTH NETWORK BENTON HARBOR FAMILY PRACTICE 16 32 $14,880 $465 0.1% 0.0% (269) 927-5400
42 ASPIRUS KEWEENAW LAURIUM FAMILY PRACTICE 109 29 $10,527 $363 0.1% 0.0% (906) 337-3100
43 KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST CLACKAMAS FAMILY PRACTICE 1828 29 $10,614 $366 0.1% 0.0% (800) 813-2000
44 GRAYSON COUNTY HEALTH CLINIC SHERMAN FAMILY PRACTICE 12 25 $3,325 $133 0.1% 0.0% (903) 771-2846
45 HOSPITAL CARE CONSULTANTS INC SALLISAW FAMILY PRACTICE 29 17 $6,579 $387 0.0% 0.0% (918) 774-1100
46 LANGLADE HOSPITAL - HOTEL DIEU OF ST JOSEPH OF ANTIGO WISCONSIN ANTIGO FAMILY PRACTICE 89 17 $5,226 $307 0.0% 0.0% (715) 623-2331
47 PROVIDENCE HEALTH AND SERVICES- WASHINGTON ANCHORAGE FAMILY PRACTICE 218 16 $8,160 $510 0.0% 0.0% (907) 562-9229

*"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 →