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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 — General Surgery: 2,152 services — specialty benchmark suppressed (fewer than 11 groups) — showing state benchmark. See General Surgery 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 HEALOGICS SPECIALTY PHYSICIANS OF MASSACHUSETTS PLLC HOLYOKE GENERAL SURGERY 10 1,037 $332,877 $321 premium 0.0% (413) 535-4741
2 ANCHOR MEDICAL GROUP AND WELLNESS CENTER PC NEW BEDFORD GENERAL SURGERY 3 384 $96,000 $250 premium 0.0% (508) 951-0847
3 ESSEX SURGICAL ASSOCIATES, PC BEVERLY GENERAL SURGERY 7 296 $108,928 $368 premium 0.0% (978) 922-9226
4 SECHOIR BLOW DRY BAR, LLC GAINESVILLE GENERAL SURGERY 5 254 $45,720 $180 premium 0.0% (703) 214-6984
5 STONY BROOK SURGICAL ASSOCIATES UNIVERSITY FACULTY PRACTICE CORPORATI HAMPTON BAYS GENERAL SURGERY 102 60 $21,600 $360 premium 0.0% (631) 723-5000
6 R LESLIE SHELTON MD PC LEOMINSTER GENERAL SURGERY 2 40 $16,000 $400 premium 0.0% (978) 840-6481
7 RIVERSIDE SURGICAL ASSOCIATES, PC LOWELL GENERAL SURGERY 8 32 $7,680 $240 premium 0.0% (978) 937-6000
8 HIGHLAND SURGICAL ASSOCIATES LLC MILTON GENERAL SURGERY 2 31 $15,500 $500 premium 0.0% (617) 696-0660
9 PRECISION SURGICAL SPECIALISTS OF LOWELL PC CHELMSFORD GENERAL SURGERY 4 18 $6,300 $350 premium 0.0% (978) 995-3292

*"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 →