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Market snapshot

99285 in DC CY2024

Medicare Part B FFS · CY2024 · as published by CMS

99285 — Emergency department visit with high level of medical decision making

Billing groups
35
Named-group FFS services
10,555
FFS of Medicare
66%
Services YoY
+7.2%
FFS enrollment -2.5%
Estimated all-Medicare volume FFS + estimated MA estimate
~15,760 services

10,555 observed fee-for-service (67%) · ~5,205 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
$9.2M
Named-group allowed amount
$1.9M
Named-group Medicare payments
$1.5M
Avg charge / svc
$873
Avg allowed / svc
$181
Avg payment / svc
$139
Average charge per group
$355 35 groups · avg submitted charge / service $3,287
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Specialty market — Emergency Medicine: 3,566 services across 18 groups; top group 13%. See Emergency Medicine across all states →

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 99285 services, CY2024
#Physician group City Specialty Providers 99285 svcs Submitted charges Avg charge Medicare $ locked column Share of specialty*Share of state* Phone
1 EMERGENCY PHYSICIANS OF TIDEWATER SUFFOLK EMERGENCY MEDICINE 165 459 $323,136 $704 premium 12.9% 1.6% (757) 686-3508
2 THE BORTOLAZZO GROUP, LLC AUSTELL EMERGENCY MEDICINE 94 381 $611,420 $1,605 premium 10.7% 1.3% (770) 732-4000
3 SANDHILLS EMERGENCY PHYSICIANS PA PINEHURST EMERGENCY MEDICINE 25 361 $549,982 $1,523 premium 10.1% 1.2% (910) 715-1116
4 PENSACOLA EMERGENCY PHYSICIANS, LLC PENSACOLA EMERGENCY MEDICINE 43 306 $497,960 $1,627 premium 8.6% 1.1% (850) 469-2313
5 FAIR OAKS EMERGENCY PHYSICIANS PLLC FAIRFAX EMERGENCY MEDICINE 19 245 $368,585 $1,504 premium 6.9% 0.8% (703) 391-3600
6 FLORIDA EMERGENCY PHYSICIANS KANG AND ASSOCIATES MD LLC ORLANDO EMERGENCY MEDICINE 310 209 $386,329 $1,848 premium 5.9% 0.7% (407) 303-5600
7 CEP AMERICA LLC DECATUR EMERGENCY MEDICINE 960 203 $248,596 $1,225 premium 5.7% 0.7% (510) 851-7493
8 MILLS-PENINSULA EMERGENCY MEDICAL ASSOCIATES, INC BURLINGAME EMERGENCY MEDICINE 30 203 $217,317 $1,071 premium 5.7% 0.7% (650) 696-5500
9 EMERGENCY PHYSICIANS SPPS BALTIMORE EMERGENCY MEDICINE 20 184 $188,316 $1,023 premium 5.2% 0.6% (410) 332-9000
10 WAKE EMERGENCY PHYSICIANS PA RALEIGH EMERGENCY MEDICINE 275 181 $169,778 $938 premium 5.1% 0.6% (919) 350-8000
11 FEDKO EMERGENCY PHYSICIANS NEW MEXICO, LLC GRANTS EMERGENCY MEDICINE 56 164 $221,392 $1,350 premium 4.6% 0.6% (505) 287-4446
12 EMERGENCY COVERAGE LLC RICHMOND EMERGENCY MEDICINE 755 122 $213,744 $1,752 premium 3.4% 0.4% (804) 289-4500
13 TAHOE EMERGENCY PHYSICIANS MEDICAL CORPORATION SOUTH LAKE TAHOE EMERGENCY MEDICINE 17 119 $175,632 $1,476 premium 3.3% 0.4% (530) 541-3420
14 SEATTLE EMERGENCY PHYSICIANS SERVICES INC PS SEATTLE EMERGENCY MEDICINE 40 109 $160,775 $1,475 premium 3.1% 0.4% (360) 658-2488
15 PROFESSIONAL EMERGENCY PHYSICIAN SERVICES, LLC OAKLAND EMERGENCY MEDICINE 13 100 $47,900 $479 premium 2.8% 0.3% (301) 533-4190
16 BETHESDA EMERGENCY ASSOCIATES, LLC BETHESDA EMERGENCY MEDICINE 10 91 $150,184 $1,650 premium 2.6% 0.3% (301) 896-3100
17 FREDERICKSBURG EMERGENCY MEDICAL ALLIANCE, INC. FREDERICKSBURG EMERGENCY MEDICINE 47 88 $145,233 $1,650 premium 2.5% 0.3% (540) 741-1167
18 UNIVERSITY HOSPITAL OF BROOKLYN SUNY DOWNSTATE HEALTH SCIENCES UNIVERS BROOKLYN EMERGENCY MEDICINE 92 41 $23,126 $564 premium 1.1% 0.1% (718) 270-1000

*"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 →