NEVVI Medicare utilization intelligence

U.S. physician groups billed Medicare about $1,017 for the average emergency-department visit in 2024 — and were paid about $113

Published Jul 2026 · CMS Part B PUF 📋 Cite See the data →
Average submitted charge vs. Medicare payment · emergency-department visit · 2024
Billed (avg): $1,017$1,017Billed (avg)Paid (avg): $113$113Paid (avg)
Average Medicare fee-for-service submitted charge and payment per emergency-department visit — the physician's professional service, not the hospital facility charge — across named physician groups, 2024. Full method below.
How unevenly the gap is spread
$0$1,000$2,000++124 groups list more, to $13,136 →one dot = one physician groupmedian group $909

The services-weighted average of $1,017 is pulled up by a right tail: the median group lists about $909, while the highest-listing tenth list about $1,593 or more.

Each dot is one of 4,217 named physician groups, placed by its average submitted charge per emergency-department visit in 2024. Submitted charges are provider-set list amounts, not payments — the spread is list-price behavior, not what Medicare pays.

Charged about 9.0 times what it paid: for the average emergency-department visit in 2024, these groups billed about $1,017 and Medicare paid about $113.

The gap is a list price set against a fee schedule. Submitted charges are amounts each group sets on its own. Medicare pays its allowed amount for the visit, whatever the list price.

Medicare is one payer. The submitted charge is a list price, and a higher one does not raise Medicare's payment. The gap measures a list price against one payer's schedule, from Medicare claims only. It says nothing about what any other payer pays.

This is the physician's fee, not the facility's. It covers the professional service for the visit itself, not the hospital's separate facility bill for the same encounter.

A record of what was billed and what Medicare paid — not a verdict on price, value, or fairness. The charge is a list amount each group sets; the payment is the fee schedule's fixed amount.

What this is

The average submitted charge and the average Medicare payment per emergency-department visit (the physician's professional service), across named physician groups, in 2024.

What it is not

Not a total-spending figure, not the hospital facility charge and not all-payer.

How this is counted
Average submitted charge and average Medicare payment per emergency-department visit, across named physician groups, 2024 — a per-service average and its ratio, not a total. This is the physician's professional service, not the hospital facility charge. Because these are per-service averages and a ratio, they are NOT scaled to total Medicare — a per-service figure is basis-independent, so no estimate or MA assumption applies. Cells under 11 beneficiaries withheld by CMS. Excludes commercial payers. Source: Medicare Part B.