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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 — Maxillofacial Surgery: 176 services — specialty benchmark suppressed (fewer than 11 groups) — showing state benchmark. See Maxillofacial Surgery 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 MAINE PROSTHODONTICS PORTLAND ME MAXILLOFACIAL SURGERY 2 56 $10,800 $193 premium 0.1% (207) 773-6177
2 POTTSTOWN ORAL AND MAXILLOFACIAL SURGERY ASSOC. INC POTTSTOWN PA MAXILLOFACIAL SURGERY 5 38 $7,220 $190 premium 0.0% (610) 326-7880
3 DRS. KOSLIN AND KAHN, P.C. JASPER AL MAXILLOFACIAL SURGERY 4 35 $4,650 $133 premium 0.0% (205) 979-9738
4 TS BILLINGS LLC PORTLAND OR MAXILLOFACIAL SURGERY 6 30 $13,230 $441 premium 0.0% (503) 528-0704
5 ORAL SURGICAL INSTITUTE PC FRANKLIN TN MAXILLOFACIAL SURGERY 2 17 $2,720 $160 premium 0.0% (615) 778-0902

*"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 →