Top 25 medical specialties by average charges

Health insurance plans negotiate reimbursement and coverage with healthcare provider organizations. As hospitals move to value-based care initiatives and concerns grow over rising healthcare costs, understanding service line revenue, charges and expenses is crucial to measuring hospital financial performance.

What are the average procedure charges for healthcare providers?

Using data from the Definitive Healthcare ClaimsMx product, we analyzed medical claims for more than 1.8 million healthcare providers across 130 primary specialties. We looked at over 3 billion 2021 procedure claims for these providers and found that the average annual charges each of these providers submitted to commercial healthcare insurance providers for reimbursement last year was about $1.2 million.

This list ranks the top medical specialties by the highest average submitted procedure charges based on 2021 claims.

Highest average procedure charges by medical specialty in 2021

Rank Medical specialty Number of providers Total procedures Average charges per provider
1 Nephrology 10,162 239,874,076 $42,982,704
2 Cardiac Electrophysiology 2,480 12,203,824 $5,568,993
3 Hematology/Oncology 9,982 56,322,457 $5,037,403
4 Medical Oncology 4,087 18,322,653 $4,400,226
5 Radiation Oncology 5,230 16,945,113 $4,217,590
6 Hand Surgery 1,717 6,702,062 $3,192,109
7 Hematology 1,016 3,733,105 $3,172,206
8 Emergency Medicine 55,027 283,462,116 $2,897,733
9 Orthopedic Surgery 25,114 84,277,671 $2,747,747
10 Interventional Cardiology 4,210 17,251,965 $2,625,423
11 Interventional Pain Management 1,642 6,251,993 $2,625,100
12 Gynecological Oncology 1,163 3,383,798 $2,546,863
13 Gastroenterology 15,832 39,065,613 $2,076,927
14 Pain Management 2,911 8,786,830 $2,046,951
15 Urology 10,551 38,681,320 $1,952,513
16 Neurosurgery 5,795 8,710,787 $1,905,202
17 Vascular Surgery 3,859 8,194,675 $1,740,080
18 Ophthalmology 18,773 59,550,212 $1,702,049
19 Sports Medicine 2,093 6,426,993 $1,632,057
20 Colorectal Surgery 1,682 3,093,264 $1,607,198
21 Otolaryngology 10,446 25,464,782 $1,548,438
22 Interventional Radiology 2,194 5,615,897 $1,516,977
23 Rheumatology 5,625 16,281,165 $1,448,946
24 Cardiologist 22,637 76,836,318 $1,439,911
25 Surgical Oncology 1,167 1,843,905 $1,415,110

Fig. 1  Data is from the Definitive Healthcare ClaimsMx product. Claims data is sourced from multiple medical claims clearinghouses in the United States and is updated monthly. Only specialties with at least 200 procedure claims in 2021 included. Data is accurate as of April 2022.

Nephrologists averaged nearly $43 million in charges per provider in 2021. The frequency and high cost of dialysis treatment likely plays a role in these results. The average charges for nephrologists is 7 times higher than the next ranked specialty, cardiac electrophysiology at $5.6 million. Hematology/oncology providers had average charges of $5 million in 2021.

Learn more

Healthcare Insights are developed with healthcare commercial intelligence from the Definitive Healthcare platform. Want even more insights? Start a free trial now and get access to the latest healthcare commercial intelligence on hospitals, physicians and other healthcare providers.

Explore our data