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Methodology•Download Data
  1. Home
  2. Deep Analysis

Deep Analysis — Exploring $940B+ in Medicare Data

Go beyond the headlines. These analyses dig into specific aspects of Medicare spending using 96 million rows of CMS physician payment data spanning 11 years (2014-2024).

$940B+
Total Payments
1.82M
Providers Analyzed
11 Years
2014-2024 Data
96M+
Rows of CMS Data
🏢

Place of Service

Office vs Facility: Where Medicare Money Flows

📍

Geographic

Spending Hotspots by City & Zip Code

⚖️

Cost Adjustment

The Geographic Cost Gap

💸

Payment Gap

Charged vs Allowed vs Paid: The Three-Way Gap

🏥

Utilization

Individual Doctors vs Corporate Medicine

📈

Markup Analysis

What Doctors Charge vs What Medicare Pays

💊

Drug Spending

Medicare's Pharmaceutical Pipeline

🌾

Rural vs Urban

The Geographic Divide in Medicare

📊

Trends

10 Years of Medicare Spending

Also Explore

🚨 Fraud Hub
📰 Investigations
👨‍⚕️ Provider Directory
🔍 Search
📍 By State
🩺 By Specialty
📋 Procedures
🧮 Calculator

What the Data Covers

DimensionCoverage
Time Period2014-2024 (11 years)
Total Payments$940B+
Unique Providers1.82 million
Total Rows96 million+
States & Territories61
Medical Specialties105+
Procedure Codes (HCPCS)7,500+
Deep-Profiled Providers30,000+
AI-Flagged for Fraud500
Investigation Articles74+

How We Analyze Medicare Data

Every analysis on OpenMedicare starts with the same foundation: CMS Medicare Provider Utilization and Payment Data, covering 11 years from 2014 through 2024. This dataset includes every payment Medicare Part B made to every physician and supplier in the United States — over 96 million individual rows of billing data.

We process this data to calculate aggregate statistics at the provider, specialty, state, and procedure level. Our analyses use standard statistical methods including peer comparison (comparing providers against specialty averages), trend analysis (year-over-year changes), geographic normalization (adjusting for cost-of-living differences), and outlier detection (identifying statistically unusual billing patterns).

For fraud-related analyses, we employ machine learning models trained on the billing patterns of 2,198 confirmed Medicare fraudsters. Our current model (v2) achieves an AUC of 0.83, meaning it correctly distinguishes between fraudulent and legitimate billing patterns 83% of the time.

What Makes Our Analysis Different

📊 Comprehensive Coverage

We don't sample — we analyze every row. All 1.82 million providers, all 96 million+ billing records, across all 50 states and territories.

📅 11-Year Longitudinal View

Most Medicare analyses look at a single year. Ours spans 2014-2024, revealing trends that only emerge over time — like the slow rise of telehealth or the steady concentration of spending.

🤖 AI-Powered Insights

Machine learning models don't just flag outliers — they identify patterns across thousands of variables that human auditors would never catch.

🔓 Fully Transparent

Every number on this site comes from publicly available CMS data. We show our sources, explain our methods, and let you verify everything yourself.

Key Findings Across Our Analyses

💊

Drug Costs Are the Fastest-Growing Category

Physician-administered drugs grew from 11% to nearly 15% of Medicare spending in a decade. A single eye injection drug costs more than most federal agencies' budgets.

📈

Markups Are Getting Worse

Providers submitted $3.5T+ in charges but Medicare paid $940B. The 3.7x average markup ratio has been climbing every year since 2014.

🌾

Rural America Is Being Left Behind

Rural providers earn less per service, treat fewer patients, and face hospital closures — while their patients are older and sicker on average.

🚨

Fraud Hides in Plain Sight

Our AI flagged 500 providers whose billing patterns match convicted fraudsters — many have been billing Medicare for years without scrutiny.

🏥

Corporate Medicine Is Growing

Large healthcare organizations receive an increasing share of Medicare payments, while solo practitioners decline. The top 1% of providers collect over 25% of all payments.

Where to Start

New here? Start with the Spending Trends page for the big picture — how Medicare spending has changed over 11 years.

Interested in fraud? Head to the Fraud Hub to see which providers our AI flagged and why.

Curious about your state? Browse State Pages for detailed breakdowns of Medicare spending in your state.

Want to look up a doctor? Use the Provider Lookup to search any of 1.82 million Medicare providers.

Checking costs? Our Cost Calculator estimates Medicare payments for any procedure combination.

Data Limitations

Part B only: Our data covers Medicare Part B (physician/supplier) payments. It does not include Part A (hospital inpatient), Part C (Medicare Advantage plan-level payments), or Part D (pharmacy) spending. Total Medicare spending across all parts exceeds $890 billion annually.

Fee-for-service: As more beneficiaries enroll in Medicare Advantage (now over 50%), our fee-for-service dataset represents a shrinking share of total Medicare beneficiaries. MA plan payments to providers are not included in CMS public use files.

Privacy thresholds: CMS suppresses data for providers with fewer than 11 beneficiaries for any given service to protect patient privacy. This means some low-volume providers and rare procedures are underrepresented in our analysis.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • CMS National Health Expenditure Data

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.