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Market snapshot

99285 in SD CY2024

Medicare Part B FFS · CY2024 · as published by CMS

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

Billing groups
24
Named-group FFS services
8,641
FFS of Medicare
63%
Services YoY
+0.3%
FFS enrollment -2.3%
Estimated all-Medicare volume FFS + estimated MA estimate
~13,495 services

8,641 observed fee-for-service (64%) · ~4,854 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
$7.3M
Named-group allowed amount
$1.4M
Named-group Medicare payments
$1.0M
Avg charge / svc
$850
Avg allowed / svc
$158
Avg payment / svc
$119
Average charge per group
$390 24 groups · avg submitted charge / service $2,194
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Specialty market — Emergency Medicine: 4,263 services — specialty benchmark suppressed (fewer than 11 groups) — showing state benchmark. 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 RAPID CITY EMERGENCY SERVICES PA RAPID CITY EMERGENCY MEDICINE 24 3,383 $2,845,103 $841 premium 15.9% (605) 755-8222
2 CEP AMERICA- ARIZONA, PC SUN CITY EMERGENCY MEDICINE 80 798 $978,178 $1,226 premium 3.7% (623) 832-4000
3 HAWK EMERGENCY GROUP, P.C. GAYLORD EMERGENCY MEDICINE 53 82 $164,838 $2,010 premium 0.4% (989) 731-2100

*"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 →