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Market snapshot

99231 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

99231 — Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes

Billing groups
5,126
Named-group FFS services
2,189,201
FFS of Medicare
49%
Services YoY
-11.9%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~4,410,876 services

2,189,201 observed fee-for-service (50%) · ~2,221,675 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; 2 states without payer-mix data excluded. How we scale

Top states — 99231 (CY2024)
FL 320,644 NY 262,846 TX 234,639 CA 221,562 PA 212,581

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

Named-group submitted charges
$266.6M
Named-group allowed amount
$102.6M
Named-group Medicare payments
$80.8M
Avg charge / svc
$122
Avg allowed / svc
$47
Avg payment / svc
$37
Average charge per group
$30 5,126 groups · avg submitted charge / service $3,547
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
#Physician group City St Specialty Providers 99231 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 OCEANSIDE MEDICAL GROUP A MEDICAL CORPORATION SANTA MONICA CA NURSE PRACTITIONER 17 20,562 $2,053,925 $100 9.3% (310) 993-4103
2 NORTHEAST FLORIDA ENDOCRINE AND DIABETES ASSOCIATES PA JACKSONVILLE FL PHYSICIAN ASSISTANT 82 19,905 $1,393,249 $70 6.2% (904) 384-2240
3 CALVARY HOSPITAL INC BRONX NY INTERNAL MEDICINE 48 16,874 $1,097,121 $65 6.4% (718) 518-2000
4 HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC NEPTUNE NJ NURSE PRACTITIONER 1878 15,757 $2,509,874 $159 11.3% (732) 362-3663
5 NORTH SHORE-LIJ MEDICAL PC MANHASSET NY PHYSICIAN ASSISTANT 6294 13,041 $2,416,519 $185 5.0% —
6 CHS PHYSICIAN PARTNERS PC ROSLYN NY PHYSICIAN ASSISTANT 734 12,696 $2,690,738 $212 4.8% —
7 REHAB AND GERIATRICS COLUMBIA SC PHYSICAL MEDICINE AND REHABILITATION 6 10,882 $1,218,864 $112 18.1% (803) 401-1369
8 MAYO CLINIC ROCHESTER MN NURSE PRACTITIONER 4896 9,927 $1,883,226 $190 28.2% (507) 284-2511
9 UNIVERSITY OF PITTSBURGH PHYSICIANS PITTSBURGH PA DIAGNOSTIC RADIOLOGY 4291 9,675 $982,124 $102 4.6% —
10 EASTERN PENNSYLVANIA PHYSICIAN ALLIANCE, LLC PHILADELPHIA PA PSYCHIATRY 108 9,010 $865,795 $96 4.2% (215) 487-4000
11 MASSACHUSETTS GENERAL PHYSICIANS ORGANIZATION INC BOSTON MA DIAGNOSTIC RADIOLOGY 3532 8,676 $1,790,977 $206 5.8% (617) 724-0287
12 ADDIS MEDICAL GROUP A MEDICAL CORPORATION LONG BEACH CA NURSE PRACTITIONER 17 8,540 $1,266,825 $148 3.9% (562) 424-0757
13 UMASS MEMORIAL MEDICAL GROUP INC WORCESTER MA PHYSICIAN ASSISTANT 2483 8,496 $1,346,603 $158 5.7% (508) 334-1000
14 NORTHEASTERN REHABILITATION ASSOCIATES, PC SCRANTON PA PHYSICAL MEDICINE AND REHABILITATION 48 8,100 $1,026,526 $127 3.8% (570) 344-3788
15 OHIOHEALTH CORPORATION COLUMBUS OH PHYSICIAN ASSISTANT 2282 7,957 $998,044 $125 7.4% —
16 FRANCISCAN PHYSICIAN NETWORK INDIANAPOLIS IN PHYSICIAN ASSISTANT 1151 7,903 $726,170 $92 10.9% —
17 NEW YORK UNIVERSITY NEW YORK NY DIAGNOSTIC RADIOLOGY 5704 7,242 $1,942,949 $268 2.8% (212) 263-9700
18 SENTARA MEDICAL GROUP NORFOLK VA PHYSICIAN ASSISTANT 1404 7,107 $803,252 $113 9.2% —
19 WELLSPAN MEDICAL GROUP YORK PA PHYSICIAN ASSISTANT 2312 7,077 $549,415 $78 3.3% —
20 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 6,620 $2,036,350 $308 6.1% —
21 WEILL MEDICAL COLLEGE OF CORNELL NEW YORK NY INTERNAL MEDICINE 2053 6,010 $930,382 $155 2.3% (212) 746-5454
22 ARKANSAS HEALTH GROUP LITTLE ROCK AR CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 666 5,984 $485,714 $81 9.1% (501) 202-2093
23 FLORIDA HOSPITAL MEDICAL GROUP INC MAITLAND FL PHYSICIAN ASSISTANT 1634 5,810 $890,667 $153 1.8% (407) 200-2700
24 ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI NEW YORK NY PHYSICIAN ASSISTANT 2818 5,517 $845,874 $153 2.1% (212) 241-4812
25 SELECT PHYSICAL THERAPY TEXAS LIMITED PARTNERSHIP HOUSTON TX ORTHOPEDIC SURGERY 463 5,499 $408,048 $74 2.3% (281) 440-7625
26 ENDEAVOR HEALTH MEDICAL GROUP EVANSTON IL NURSE PRACTITIONER 3380 5,496 $531,525 $97 4.7% —
27 BERGEN COUNTY IMPROVEMENT AUTHORITY PARAMUS NJ INTERNAL MEDICINE 97 5,479 $749,135 $137 3.9% (201) 967-4000
28 WELLSTAR MEDICAL GROUP LLC MARIETTA GA NURSE PRACTITIONER 3060 5,417 $518,844 $96 7.3% (770) 422-2004
29 VIRTUA MEDICAL GROUP, PA VOORHEES NJ PHYSICIAN ASSISTANT 1662 5,375 $641,947 $119 3.9% (856) 247-7260
30 WASHINGTON UNIVERSITY SAINT LOUIS MO NURSE PRACTITIONER 3070 5,337 $772,318 $145 6.1% (314) 747-3000
31 TEXAS HEALTH PHYSICIANS GROUP FORT WORTH TX PHYSICIAN ASSISTANT 1350 5,274 $671,833 $127 2.2% (817) 281-2977
32 MAYO CLINIC JACKSONVILLE JACKSONVILLE FL NURSE PRACTITIONER 1587 5,215 $967,372 $185 1.6% (904) 953-2000
33 CHRISTIANA CARE HEALTH SERVICES INC NEWARK DE PHYSICIAN ASSISTANT 1537 5,128 $615,657 $120 24.8% —
34 W DEAN LORENZ MD PC FLORENCE SC PHYSICAL MEDICINE AND REHABILITATION 2 5,099 $305,940 $60 8.5% (843) 661-4390
35 NORTHEAST BEHAVIORAL HEALTH LLC DARTMOUTH MA NURSE PRACTITIONER 19 5,097 $611,640 $120 3.4% (508) 207-9800
36 JOHNS HOPKINS UNIVERSITY BALTIMORE MD NURSE PRACTITIONER 2900 5,085 $796,038 $157 8.6% (410) 502-4340
37 LEE HEALTH SYSTEM INC FORT MYERS FL NURSE PRACTITIONER 1370 5,069 $730,373 $144 1.6% (239) 343-9888
38 LEXINGTON HEALTH INC WEST COLUMBIA SC NURSE PRACTITIONER 909 4,912 $504,345 $103 8.1% (803) 744-4900
39 NORTHWESTERN MEDICAL FACULTY FOUNDATION CHICAGO IL NURSE PRACTITIONER 4339 4,828 $572,615 $119 4.1% —
40 WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES PC VALHALLA NY DIAGNOSTIC RADIOLOGY 875 4,827 $727,311 $151 1.8% —
41 ALLEGHENY CLINIC PITTSBURGH PA PHYSICIAN ASSISTANT 2293 4,824 $687,816 $143 2.3% —
42 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 4,740 $807,097 $170 2.1% (650) 723-4000
43 HMH CARRIER BEHAVIORAL HEALTH INC BELLE MEAD NJ PSYCHIATRY 45 4,682 $469,965 $100 3.4% (908) 281-1000
44 FOUNTAIN VALLEY CARDIOLOGY MEDICAL CLINIC INC FOUNTAIN VALLEY CA INTERNAL MEDICINE 2 4,639 $556,680 $120 2.1% (714) 540-9911
45 MAINEHEALTH PORTLAND ME NURSE PRACTITIONER 2574 4,527 $474,982 $105 32.2% (207) 885-9905
46 NORTH FLORIDA SURGEONS PA JACKSONVILLE FL PHYSICIAN ASSISTANT 331 4,526 $512,475 $113 1.4% (904) 396-1725
47 BAPTIST HEALTH MEDICAL GROUP INC LOUISVILLE KY NURSE PRACTITIONER 2448 4,449 $343,195 $77 6.2% (502) 928-1050
48 RIVERSIDE PHYSICIAN SERVICES INC NEWPORT NEWS VA PHYSICIAN ASSISTANT 793 4,428 $328,149 $74 5.7% —
49 BAPTIST HEALTH MEDICAL GROUP PHYSICIANS LLC SOUTH MIAMI FL PHYSICIAN ASSISTANT 653 4,319 $590,704 $137 1.3% (786) 662-0600
50 COUNTY OF SANTA CLARA SAN JOSE CA INTERNAL MEDICINE 1001 4,275 $1,596,352 $373 1.9% (408) 885-5000
51 HARTFORD HEALTHCARE MEDICAL GROUP SPECIALISTS PLLC STORRS CT PHYSICIAN ASSISTANT 1493 4,269 $502,626 $118 8.1% (860) 724-2579
52 NEUROSCIENCE SPECIALISTS PC OKLAHOMA CITY OK NEUROSURGERY 16 4,233 $275,145 $65 11.5% (405) 748-3300
53 JERROLD DREYER MD INC SHERMAN OAKS CA INFECTIOUS DISEASE 2 4,220 $358,700 $85 1.9% (818) 784-3615
54 OSF MULTI-SPECIALTY GROUP PEORIA IL NURSE PRACTITIONER 2091 4,214 $608,257 $144 3.6% (309) 683-5050
55 PROVIDENCE MEDICAL FOUNDATION FULLERTON CA PHYSICIAN ASSISTANT 1455 4,213 $625,474 $148 1.9% (714) 871-3006
56 PRACTICE ASSOCIATES MEDICAL GROUP MORRISTOWN NJ NURSE PRACTITIONER 1404 4,191 $525,867 $125 3.0% (973) 971-5596
57 STATE UNIVERSITY OF IOWA IOWA CITY IA PHYSICIAN ASSISTANT 1902 4,155 $698,688 $168 10.1% (319) 678-8201
58 EAST CAROLINA ANESTHESIA ASSOCIATES PLLC GREENVILLE NC CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 673 4,146 $1,206,486 $291 6.3% (252) 847-4100
59 BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC BOSTON MA PHYSICIAN ASSISTANT 2942 4,129 $852,437 $206 2.8% (617) 732-5500
60 BAPTIST PRIMARY CARE INC JACKSONVILLE FL FAMILY PRACTICE 446 4,099 $499,954 $122 1.3% —
61 IHC HEALTH SERVICES INC MURRAY UT PHYSICIAN ASSISTANT 3944 4,091 $461,473 $113 45.7% (801) 261-8346
62 PAM PHYSICIAN ENTERPRISE SAN ANTONIO TX PHYSICAL MEDICINE AND REHABILITATION 33 4,079 $481,500 $118 1.7% (210) 581-5300
63 INOVA HEALTH CARE SERVICES FALLS CHURCH VA NURSE PRACTITIONER 1818 3,980 $384,804 $97 5.1% —
64 INTEGRATED MEDICAL PROFESSIONALS PLLC SEAFORD NY UROLOGY 98 3,954 $680,404 $172 1.5% (516) 520-8080
65 SUMMIT MEDICAL GROUP INC EDGEWOOD KY NURSE PRACTITIONER 806 3,905 $468,027 $120 5.5% (859) 578-5880
66 PHYSICIAN GROUPS LC SAINT LOUIS MO NURSE PRACTITIONER 516 3,858 $334,869 $87 4.4% (314) 273-0195
67 REGIONAL GASTROENTEROLOGY ASSOCIATES OF LANCASTER, LTD. LANCASTER PA PHYSICIAN ASSISTANT 259 3,825 $325,125 $85 1.8% (717) 869-4600
68 UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES LITTLE ROCK AR NURSE PRACTITIONER 1241 3,823 $384,476 $101 5.8% (501) 686-8000
69 UHS OF FULLER INC SOUTH ATTLEBORO MA NURSE PRACTITIONER 21 3,821 $252,259 $66 2.6% —
70 CHRISTUS TRINITY CLINIC TYLER TX NURSE PRACTITIONER 1495 3,817 $347,849 $91 1.6% (903) 606-5560
71 DIABETES MANAGEMENT PARTNERS LLC BIRMINGHAM AL NURSE PRACTITIONER 60 3,770 $227,972 $60 6.8% (904) 372-3943
72 WAKEMED SPECIALISTS GROUP LLC RALEIGH NC PHYSICIAN ASSISTANT 860 3,729 $386,952 $104 5.7% (919) 350-7270
73 CENTER FOR FAMILY GUIDANCE PC MARLTON NJ NURSE PRACTITIONER 168 3,712 $592,750 $160 2.7% (856) 983-3900
74 LANCASTER GENERAL HOSPITAL LANCASTER PA NURSE PRACTITIONER 511 3,699 $296,227 $80 1.7% (267) 857-7751
75 SOUTH TEXAS PM AND R GROUP, INC SAN ANTONIO TX PHYSICAL MEDICINE AND REHABILITATION 3 3,662 $411,060 $112 1.6% (210) 615-2225
76 HARTFORD HOSPITAL HARTFORD CT PHYSICIAN ASSISTANT 1045 3,643 $440,829 $121 6.9% (860) 696-5950
77 NORTH TEXAS PHYSICIAN SERVICES, PLLC TYLER TX INTERNAL MEDICINE 235 3,625 $331,635 $91 1.5% (903) 593-8441
78 LEHIGH VALLEY PHYSICIAN GROUP ALLENTOWN PA PHYSICIAN ASSISTANT 2389 3,560 $526,028 $148 1.7% —
79 CENTRAL DUPAGE PHYSICIAN GROUP WHEATON IL PHYSICIAN ASSISTANT 1097 3,483 $355,790 $102 3.0% (630) 933-4800
80 ALBANY MEDICAL COLLEGE ALBANY NY PHYSICIAN ASSISTANT 1070 3,478 $404,053 $116 1.3% (518) 262-3277
81 JOHN MUIR PHYSICIAN NETWORK WALNUT CREEK CA FAMILY PRACTICE 489 3,476 $524,836 $151 1.6% (925) 296-9720
82 CENTRA MEDICAL GROUP LLC LYNCHBURG VA NURSE PRACTITIONER 714 3,468 $268,958 $78 4.5% (434) 947-3033
83 BARNABAS HEALTH MEDICAL GROUP, PC NEWARK NJ PSYCHIATRY 254 3,459 $705,709 $204 2.5% (973) 926-7814
84 FAIRVIEW HEIGHTS MEDICAL GROUP SC SHILOH IL NURSE PRACTITIONER 445 3,443 $309,408 $90 3.0% (618) 236-8000
85 PHYSICIANS REFERRAL SERVICE HOUSTON TX NURSE PRACTITIONER 2696 3,430 $595,953 $174 1.5% (713) 592-5433
86 HEARTLAND REGIONAL MEDICAL CENTER SAINT JOSEPH MO NURSE PRACTITIONER 387 3,408 $357,486 $105 3.9% (816) 271-6870
87 FRANCISCAN MEDICAL GROUP TACOMA WA PHYSICIAN ASSISTANT 1407 3,382 $537,168 $159 7.3% (253) 428-2200
88 WOUND CARE ASSOCIATES LLC HAMMOND LA NURSE PRACTITIONER 120 3,344 $253,061 $76 4.7% (985) 892-7070
89 UNIVERSITY OF LOUISVILLE PHYSICIANS INC LOUISVILLE KY NURSE PRACTITIONER 1442 3,259 $397,366 $122 4.6% (502) 629-2398
90 COTTON-O'NEIL CLINIC REVOCABLE TRUST TOPEKA KS NURSE PRACTITIONER 649 3,243 $252,954 $78 8.7% (785) 354-9591
91 HEARTLAND CARDIOLOGY, LLC WICHITA KS NURSE PRACTITIONER 27 3,240 $252,762 $78 8.7% (316) 686-5300
92 STONY BROOK INTERNISTS UNIVERSITY FACULTY PRACTICE CORPORATION STONY BROOK NY HOSPITALIST 414 3,236 $481,815 $149 1.2% (631) 444-1560
93 FLORIDA CLINICAL PRACTICE ASSOCIATION INC GAINESVILLE FL NURSE PRACTITIONER 1912 3,233 $595,778 $184 1.0% (352) 265-8990
94 GENESISCARE USA OF FLORIDA LLC CAPE CORAL FL UROLOGY 175 3,177 $404,940 $127 1.0% —
95 ALLINA HEALTH SYSTEM MINNEAPOLIS MN PHYSICIAN ASSISTANT 3855 3,118 $545,207 $175 8.8% (612) 863-4000
96 PRISMA HEALTH UNIVERSITY MEDICAL GROUP GREENVILLE SC NURSE PRACTITIONER 2447 3,116 $291,090 $93 5.2% —
97 SOUTHCOAST PHYSICIANS GROUP INC FALL RIVER MA NURSE PRACTITIONER 868 3,107 $463,538 $149 2.1% (508) 973-5919
98 YALE UNIVERSITY NEW HAVEN CT PHYSICIAN ASSISTANT 2649 3,100 $431,849 $139 5.9% (203) 688-4242
99 BARNABAS HEALTH MEDICAL GROUP PC LIVINGSTON NJ NURSE PRACTITIONER 990 3,099 $788,502 $254 2.2% —
100 APPALACHIAN REGIONAL HEALTHCARE INC HAZARD KY NURSE PRACTITIONER 277 3,082 $292,790 $95 4.3% (606) 439-1316

Showing the top 100 of 5,126 groups — the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. 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 →