Data Analysis
Medicare Costs by Specialty in Illinois
Medicare reimbursement rates vary significantly across medical specialties. This analysis examines average Medicare payments per service for providers in Illinois, ranked by reimbursement level. Understanding these differences helps contextualize specialty costs and resource allocation across the healthcare system.
Context: Industry payments to physicians are legally required to be disclosed under the Physician Payments Sunshine Act.
Receiving payments does not imply wrongdoing. Payments may reflect consulting expertise, research participation, or speaking engagements.
This data is provided to support transparency, not to render clinical judgments.
Average Medicare Payment by Specialty — Illinois
CMS Open Payments| # | Specialty | Avg Medicare Payment | Providers | Total Services |
|---|---|---|---|---|
| 1 | Wound Care Registered Nurse | $366 | 2 | 2,328 |
| 2 | $343 | 1 | 723 | |
| 3 | Pediatric Critical Care | $273 | 7 | 1,271 |
| 4 | Thoracic Surgery | $272 | 98 | 25,048 |
| 5 | Clinical & Laboratory Dermatological Immunology Physician | $253 | 2 | 8,156 |
| 6 | Transplant Surgery Physician | $209 | 32 | 7,849 |
| 7 | Student Health Clinic/Center | $193 | 1 | 59 |
| 8 | Phlebology Physician | $187 | 19 | 23,323 |
| 9 | Nuclear Medicine | $179 | 11 | 17,429 |
| 10 | Neurology with Special Qualifications in Child Neurology Physician | $174 | 6 | 5,807 |
| 11 | Pediatric Ophthalmology and Strabismus Specialist Physician Physician | $150 | 5 | 4,549 |
| 12 | Neurological Surgery | $145 | 152 | 71,660 |
| 13 | Neurocritical Care Physician | $134 | 19 | 6,207 |
| 14 | Military Health Care Provider | $126 | 1 | 45 |
| 15 | Oral & Maxillofacial Surgery (D.M.D.) | $125 | 4 | 560 |
| 16 | Therapeutic Radiology Physician | $124 | 6 | 18,561 |
| 17 | Rehabilitation Clinic | $124 | 1 | 219 |
| 18 | Surgical Oncology Physician | $124 | 37 | 9,285 |
| 19 | Pediatric Nephrology | $122 | 1 | 20 |
| 20 | Sports Medicine (Emergency Medicine) Physician | $122 | 4 | 1,859 |
| 21 | MOHS-Micrographic Surgery Physician | $121 | 20 | 69,574 |
| 22 | Anesthesiologist Assistant | $119 | 2 | 208 |
| 23 | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | $118 | 2 | 787 |
| 24 | Hospice and Palliative Medicine (Anesthesiology) Physician | $117 | 1 | 94 |
| 25 | Addiction (Substance Use Disorder) Psychologist | $117 | 1 | 303 |
| 26 | Optometric Technician | $115 | 1 | 2,837 |
| 27 | Critical Care Medicine (Anesthesiology) Physician | $115 | 32 | 5,821 |
| 28 | Marriage & Family Therapist | $114 | 1 | 280 |
| 29 | Integrative Medicine Physician | $113 | 1 | 95 |
| 30 | Vascular Surgery | $112 | 38 | 7,029 |
State payment context — Illinois
CMS Open PaymentsAcross 59,986 Illinois providers with at least one disclosed industry payment over 2018–2024, the median provider received $315 in total payments, compared with a national median of $339 across 1,571,086 paid providers.
Illinois accounts for 3.8% of the $16,205,257,917 in industry payments recorded nationwide in this database, and its per-provider median runs below the national benchmark.
Top specialties by median industry payment — Illinois
| Specialty | Median per provider | Providers paid | Total payments |
|---|---|---|---|
| Clinical Cardiac Electrophysiology Physician | $14,847 | 69 | $5,434,429 |
| Adult Reconstructive Orthopaedic Surgery Physician | $14,120 | 58 | $26,043,733 |
| Sports Medicine (Orthopaedic Surgery) Physician | $8,076 | 103 | $25,980,266 |
| Orthopaedic Surgery of the Spine Physician | $7,638 | 63 | $10,347,649 |
| Orthopaedic Foot and Ankle Surgery Physician | $6,701 | 26 | $4,726,357 |
Industry payments in Illinois by year
| Year | Total payments | Providers paid | Transactions |
|---|---|---|---|
| 2018 | $78,463,780 | 24,458 | 388,152 |
| 2019 | $84,962,090 | 24,119 | 377,939 |
| 2020 | $61,771,800 | 18,403 | 193,418 |
| 2021 | $73,903,358 | 27,703 | 357,239 |
| 2022 | $98,821,349 | 31,130 | 417,139 |
| 2023 | $113,279,390 | 34,642 | 483,140 |
| 2024 | $100,875,573 | 36,678 | 515,081 |
Methodology
Average Medicare payment per service calculated from Medicare Part B Utilization data for providers licensed in Illinois. Only specialties with at least one recorded procedure are included. Average reflects the mean of per-service payment amounts across all procedures within each specialty grouping, not total expenditure. Data source: CMS Medicare Part B Utilization, accessed via doctransparency.com database.