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.

Highest average procedure charges by medical specialty in 2021

RankMedical specialtyNumber of providersTotal proceduresAverage charges per providerExplore dataset
1Nephrology10,162239,874,076$42,982,704 Explore
2Cardiac Electrophysiology2,48012,203,824$5,568,993 Explore
3Hematology/Oncology9,98256,322,457$5,037,403 Explore
4Medical Oncology4,08718,322,653$4,400,226 Explore
5Radiation Oncology5,23016,945,113$4,217,590 Explore
6Hand Surgery1,7176,702,062$3,192,109 Explore
7Hematology1,0163,733,105$3,172,206 Explore
8Emergency Medicine55,027283,462,116$2,897,733 Explore
9Orthopedic Surgery25,11484,277,671$2,747,747 Explore
10Interventional Cardiology4,21017,251,965$2,625,423 Explore
11Interventional Pain Management1,6426,251,993$2,625,100 Explore
12Gynecological Oncology1,1633,383,798$2,546,863 Explore
13Gastroenterology15,83239,065,613$2,076,927 Explore
14Pain Management2,9118,786,830$2,046,951 Explore
15Urology10,55138,681,320$1,952,513 Explore
16Neurosurgery5,7958,710,787$1,905,202 Explore
17Vascular Surgery3,8598,194,675$1,740,080 Explore
18Ophthalmology18,77359,550,212$1,702,049 Explore
19Sports Medicine2,0936,426,993$1,632,057 Explore
20Colorectal Surgery1,6823,093,264$1,607,198 Explore
21Otolaryngology10,44625,464,782$1,548,438 Explore
22Interventional Radiology2,1945,615,897$1,516,977 Explore
23Rheumatology5,62516,281,165$1,448,946 Explore
24Cardiologist22,63776,836,318$1,439,911 Explore
25Surgical Oncology1,1671,843,905$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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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.