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Market snapshot

99215 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

99215 — Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more

Billing groups
13,163
Named-group FFS services
8,142,869
FFS of Medicare
49%
Services YoY
+6.3%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~16,301,994 services

8,142,869 observed fee-for-service (50%) · ~8,159,125 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; 4 states without payer-mix data excluded. How we scale

Top states — 99215 (CY2024)

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Named-group submitted charges
$3.4B
Named-group allowed amount
$1.3B
Named-group Medicare payments
$971.2M
Avg charge / svc
$420
Avg allowed / svc
$162
Avg payment / svc
$119
Average charge per group
$60 13,163 groups · avg submitted charge / service $2,357
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Specialty market — General Practice: 6,268 services across 55 groups; top group 15%. See General Practice across all states →

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 99215 services, CY2024
#Physician group City St Specialty Providers 99215 svcs Submitted charges Avg charge Medicare $ locked column Share of specialty*Share of state* Phone
1 RONNIE CLAIBORNE MD A PROFESSIONAL CORPORATION BAKERSFIELD CA GENERAL PRACTICE 2 945 $205,476 $217 premium 37.3% 0.1% (661) 323-2295
2 GREGORY W SENSENICH INC CHILLICOTHE MO GENERAL PRACTICE 2 878 $153,650 $175 premium 0.6% (660) 646-0000
3 ARCH STREET MEDICAL ASSOCIATES REDWOOD CITY CA GENERAL PRACTICE 2 731 $213,215 $292 premium 28.9% 0.0% (650) 366-1141
4 HANOVER CONTINUITY CLINIC, PLLC HANOVER NH GENERAL PRACTICE 2 287 $107,625 $375 premium 0.4% (603) 643-3320
5 COMPLETE WOUND CARE LLC WALLINGFORD CT GENERAL PRACTICE 7 274 $131,246 $479 premium 0.2% (203) 408-2462
6 MANZANO MEDICAL GROUP, P.C. ALBUQUERQUE NM GENERAL PRACTICE 2 168 $50,500 $301 premium 0.2% (505) 727-4919
7 GILBERT MEDICAL GROUP INC HOLLYWOOD FL GENERAL PRACTICE 2 160 $48,320 $302 premium 0.0% (954) 962-2309
8 DR JOHN TRZESNIOWSKI LLC PHILA PA GENERAL PRACTICE 2 155 $38,750 $250 premium 0.0% (215) 426-3610
9 MCKNIGHT CLINIC PLLC SOMERVILLE TN GENERAL PRACTICE 2 153 $41,616 $272 premium 0.1% 9014656353110
10 THUNDER ORTHOPEDICS, LLC CHARLOTTESVILLE VA GENERAL PRACTICE 3 150 $37,613 $251 premium 0.0% (434) 326-5815
11 J AND M LAUREL MEDICAL CENTER INC PACOIMA CA GENERAL PRACTICE 2 149 $41,250 $277 premium 5.9% 0.0% (818) 897-7730
12 ALL FAMILY CARE PC PHOENIX AZ GENERAL PRACTICE 3 141 $27,777 $197 premium 0.0% (623) 872-1818
13 MACER MEDICAL ROLLING HILLS ESTATES CA GENERAL PRACTICE 3 137 $27,811 $203 premium 5.4% 0.0% (310) 541-8400
14 BREASTLINK MEDICAL GROUP INC ORANGE CA GENERAL PRACTICE 2 123 $34,440 $280 premium 4.9% 0.0% (714) 571-5900
15 DALLAS REGENERATIVE AND NEUROPATHY CENTER PLLC PLANO TX GENERAL PRACTICE 3 107 $36,884 $345 premium 0.0% (469) 209-8100
16 JOSE A L MONTEIRO MD PC FALL RIVER MA GENERAL PRACTICE 3 89 $22,250 $250 premium 0.0% 5086745200230
17 VITAL TOTAL HEALTH MEDICAL GROUP INC WALNUT CREEK CA GENERAL PRACTICE 5 85 $44,200 $520 premium 3.4% 0.0% (925) 388-9800
18 NORTH PACIFIC MEDICAL CENTER KODIAK AK GENERAL PRACTICE 2 83 $29,420 $354 premium 0.2% (907) 486-4183
19 PETER R HONIG DO PC PHILADELPHIA PA GENERAL PRACTICE 2 83 $23,510 $283 premium 0.0% (215) 467-7666
20 SOUTHSIDE MEDICAL CARE UNION CITY GA GENERAL PRACTICE 2 82 $24,190 $295 premium 0.0% (770) 964-1400
21 HEALTH RUS URGENT CARE CORP VICTORVILLE CA GENERAL PRACTICE 2 82 $6,545 $80 premium 3.2% 0.0% (909) 908-0371
22 ABDOLREZA VADIEE, INC. CHALMETTE LA GENERAL PRACTICE 2 79 $32,074 $406 premium 0.1% (504) 278-1414
23 COMPLETE CARE MANAGEMENT SERVICES ACO LLC MIRAMAR FL GENERAL PRACTICE 2 78 $17,079 $219 premium 0.0% (877) 212-2267
24 HOMETOWN FAMILY CARE, LLC COOKEVILLE TN GENERAL PRACTICE 2 72 $14,040 $195 premium 0.0% (931) 854-0050
25 BETTERIDGE AND MCNAUGHTON PS INC TACOMA WA GENERAL PRACTICE 2 67 $16,750 $250 premium 0.0% (253) 472-4473
26 DEON D MIDDLEBROOK M D PC DETROIT MI GENERAL PRACTICE 2 59 $13,334 $226 premium 0.0% (313) 864-3000
27 CENTER HILL MEDICAL, PLLC SMITHVILLE TN GENERAL PRACTICE 2 54 $9,450 $175 premium 0.0% (615) 597-4049
28 THE DOCTORS CENTER INC JACKSONVILLE FL GENERAL PRACTICE 11 50 $18,300 $366 premium 0.0% (904) 861-1900
29 MEDICAL CONSULTANTS OF FLORIDA LLC KISSIMMEE FL GENERAL PRACTICE 34 50 $7,091 $142 premium 0.0% (407) 288-8242
30 SOUTHERN MEDICAL SERVICES OF LOUISIANA, LLC BASTROP LA GENERAL PRACTICE 2 46 $14,264 $310 premium 0.0% (318) 556-3333
31 MAIN STREET MEDICAL PC HILTON HEAD SC GENERAL PRACTICE 2 40 $9,000 $225 premium 0.0% (843) 681-3777
32 PROJECT ACCESS FOUNDATION INC MIAMI FL GENERAL PRACTICE 9 39 $17,269 $443 premium 0.0% (305) 759-4778
33 PATRICK AND EDIVINA GONZALES MEDICAL GROUP INC MENIFEE CA GENERAL PRACTICE 2 39 $7,800 $200 premium 1.5% 0.0% (301) 301-3588
34 SEGARS MEDICAL GROUP SAN FRANCISCO CA GENERAL PRACTICE 2 39 $13,650 $350 premium 1.5% 0.0% (415) 452-1200
35 MONIQUE BROWN MD PC ROCKY MOUNT NC GENERAL PRACTICE 2 35 $10,896 $311 premium 0.0% 25293730225
36 FRONTIER MEDICAL GROUP LLC LAS VEGAS NV GENERAL PRACTICE 2 33 $18,770 $569 premium 0.0% (702) 686-8180
37 GOBIERNO MUNICIPAL DE CAYEY CAYEY PR GENERAL PRACTICE 4 32 $4,519 $141 premium 1.1% (787) 738-3011
38 VAL SHULMAN M D INC W HOLLYWOOD CA GENERAL PRACTICE 2 31 $7,750 $250 premium 1.2% 0.0% (323) 878-2523
39 WILLIAM GARNICA A MEDICAL CORPORATION FRESNO CA GENERAL PRACTICE 2 30 $8,820 $294 premium 1.2% 0.0% (559) 233-0335
40 MARK D. DEPONTE, M.D.,LLC LISBON CT GENERAL PRACTICE 3 28 $5,880 $210 premium 0.0% (860) 376-4451
41 S DHAND M D INC WEST COVINA CA GENERAL PRACTICE 2 28 $10,600 $379 premium 1.1% 0.0% (626) 960-7759
42 CORPORACION SERVICIOS MEDICOS PRIMARIOS Y PREVENCION DE HATILLO HATILLO PR GENERAL PRACTICE 11 27 $3,870 $143 premium 0.9% 7878984190406
43 AUBURN MEDICAL GROUP, INC AUBURN CA GENERAL PRACTICE 3 26 $5,590 $215 premium 1.0% 0.0% (530) 886-8630
44 SUNSHINE SPECIALTY HEALTH CARE, LLC ORLANDO FL GENERAL PRACTICE 3 25 $9,375 $375 premium 0.0% (407) 888-5980
45 CAREMAX CLINIC 711 LLC JACKSONVILLE FL GENERAL PRACTICE 3 22 $11,181 $508 premium 0.0% (904) 289-1254
46 MESCALERO INDIAN HOSPITAL MESCALERO MT GENERAL PRACTICE 11 21 $7,255 $345 premium 0.0%
47 HAMPTON T GASKINS MD INC RIVERSIDE CA GENERAL PRACTICE 2 21 $3,894 $185 premium 0.8% 0.0% (951) 784-0444
48 PRIORITY FAMILY CARE CENTER APC LOS ANGELES CA GENERAL PRACTICE 9 20 $6,000 $300 premium 0.8% 0.0% (213) 376-3762
49 AIRPARK PRIMARY CARE LLC WESTMINSTER MD GENERAL PRACTICE 2 20 $3,860 $193 premium 0.0% (410) 848-8882
50 IRFAN TAHIR MD PLLC LAS VEGAS NV GENERAL PRACTICE 2 18 $3,600 $200 premium 0.0% (702) 463-3333
51 CIRCE HEALTHCARE SOLUTIONS INC PALM DESERT CA GENERAL PRACTICE 2 16 $4,560 $285 premium 0.6% 0.0% (760) 773-4948
52 PROFESSIONAL PSYCHIATRIC SERVICES ORLANDO FL GENERAL PRACTICE 6 16 $3,632 $227 premium 0.0% (407) 734-1273
53 DOCTORS OFFICE AND WALK IN CLINIC CA INC SAN DIEGO CA GENERAL PRACTICE 2 15 $4,575 $305 premium 0.6% 0.0% (858) 483-5570
54 CENTRAL MEDICAL BUSINESS MANAGEMENT GLENDALE CA GENERAL PRACTICE 2 15 $4,500 $300 premium 0.6% 0.0% (818) 247-9717
55 PAULA KADISON MD PC ASPEN CO GENERAL PRACTICE 2 15 $4,485 $299 premium 0.0% (970) 379-1240

*"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 →