Data Analysis
Medicare Costs by Specialty in Pennsylvania
Medicare reimbursement rates vary significantly across medical specialties. This analysis examines average Medicare payments per service for providers in Pennsylvania, 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 — Pennsylvania
CMS Open Payments| # | Specialty | Avg Medicare Payment | Providers | Total Services |
|---|---|---|---|---|
| 1 | Dentist - General Practice | $855 | 3 | 462 |
| 2 | Phlebology Physician | $256 | 2 | 1,044 |
| 3 | Thoracic Surgery | $215 | 142 | 30,728 |
| 4 | Neurological Surgery | $172 | 231 | 70,354 |
| 5 | Prosthodontics | $154 | 2 | 275 |
| 6 | Pediatric Dermatology Physician | $146 | 4 | 8,459 |
| 7 | Ophthalmic Technician/Technologist | $145 | 1 | 4,341 |
| 8 | Clinical Genetics (M.D.) Physician | $140 | 1 | 15 |
| 9 | Transplant Surgery Physician | $140 | 25 | 6,681 |
| 10 | Plastic Surgery | $140 | 85 | 25,589 |
| 11 | Pediatric Gastroenterology | $126 | 3 | 1,489 |
| 12 | Pediatric Orthopaedic Surgery Physician | $126 | 1 | 219 |
| 13 | Clinical Biochemical Genetics Physician | $125 | 1 | 50 |
| 14 | Rural Acute Care Hospital | $125 | 1 | 28 |
| 15 | Neurocritical Care Physician | $120 | 8 | 1,897 |
| 16 | Colon & Rectal Surgery | $120 | 63 | 31,296 |
| 17 | Oral Medicine Dentistry | $116 | 1 | 13 |
| 18 | Gynecologic Oncology Physician | $114 | 43 | 9,080 |
| 19 | Adult Development & Aging Psychologist | $114 | 1 | 355 |
| 20 | Critical Care Medicine (Obstetrics & Gynecology) Physician | $113 | 1 | 32 |
| 21 | Surgical Oncology Physician | $111 | 43 | 11,006 |
| 22 | Hospice and Palliative Medicine (Emergency Medicine) Physician | $111 | 2 | 391 |
| 23 | Health Service Psychologist | $111 | 2 | 1,161 |
| 24 | Acute Care Clinical Nurse Specialist | $110 | 3 | 159 |
| 25 | Medical Toxicology (Emergency Medicine) Physician | $110 | 10 | 2,361 |
| 26 | Pediatric Ophthalmology and Strabismus Specialist Physician Physician | $106 | 3 | 1,516 |
| 27 | Personal Emergency Response Attendant | $106 | 3 | 1,543 |
| 28 | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | $105 | 2 | 998 |
| 29 | Vascular Surgery | $104 | 40 | 15,145 |
| 30 | Dentist | $102 | 14 | 842 |
State payment context — Pennsylvania
CMS Open PaymentsAcross 70,929 Pennsylvania providers with at least one disclosed industry payment over 2018–2024, the median provider received $298 in total payments, compared with a national median of $339 across 1,571,086 paid providers.
Pennsylvania accounts for 4.0% 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 — Pennsylvania
| Specialty | Median per provider | Providers paid | Total payments |
|---|---|---|---|
| Clinical Cardiac Electrophysiology Physician | $17,608 | 108 | $11,016,576 |
| Adult Reconstructive Orthopaedic Surgery Physician | $9,229 | 48 | $44,922,110 |
| Orthopaedic Surgery of the Spine Physician | $6,341 | 36 | $11,773,990 |
| Interventional Cardiology | $5,493 | 153 | $7,361,758 |
| Sports Medicine (Orthopaedic Surgery) Physician | $4,377 | 81 | $2,039,692 |
Industry payments in Pennsylvania by year
| Year | Total payments | Providers paid | Transactions |
|---|---|---|---|
| 2018 | $93,521,900 | 27,498 | 503,828 |
| 2019 | $98,262,053 | 27,073 | 479,468 |
| 2020 | $65,995,871 | 20,797 | 250,083 |
| 2021 | $88,197,557 | 32,089 | 484,645 |
| 2022 | $92,559,853 | 36,958 | 559,627 |
| 2023 | $108,431,308 | 40,464 | 625,872 |
| 2024 | $103,942,204 | 42,325 | 658,474 |
Methodology
Average Medicare payment per service calculated from Medicare Part B Utilization data for providers licensed in Pennsylvania. 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.