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