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Investigation

The Highest-Paid Doctors in Medicare: Who Earns the Most from Taxpayers?

Published February 2026 · 14 min read

Key Finding

The average Medicare provider receives $49,700 per year. But the top earners bill $10 million to $20 million+ individually. The highest-paid specialty — ophthalmology — averages $384,000 per provider, while nurse practitioners average just $26,000. The top 1% of providers collect a disproportionate share of the $854.8 billion Medicare pays annually.

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⚠️ Important Context

All data on this page comes from publicly available CMS Medicare payment records. Unusual billing patterns may reflect legitimate medical practices (such as high-volume drug administration where each unit is counted as a separate service), data reporting differences, or group practice billing. Inclusion on this page does not constitute an accusation of fraud or wrongdoing. Only law enforcement and regulatory agencies can determine whether billing patterns represent fraud. Providers flagged by our statistical model have billing patterns similar to previously convicted providers, but many may have perfectly legitimate explanations.

The Medicare Millionaire Club

When people think of Medicare payments, they imagine modest reimbursements to family doctors. The reality is far more concentrated. Among 1.72 million providers who billed Medicare in 2023, a small elite collected extraordinary sums.

We identified over 1,000 individual providers who each received more than $5 million from Medicare in a single year. At the very top, individual physicians billed upwards of $20 million — more than what some rural hospitals receive.

Explore the full Millionaire Club analysis →

The Highest-Paid Specialties

Specialty determines more about Medicare earnings than almost any other factor. Here are the top-earning specialties by average payment per provider:

#1
Ophthalmology

Retinal injections (Eylea/Lucentis) + cataract surgery

$384,000/yr
#2
Radiation Oncology

Complex radiation therapy planning & delivery

$347,000/yr
#3
Medical Oncology

Chemotherapy drug administration (Part B drugs)

$321,000/yr
#4
Cardiology

Cardiac catheterization, echocardiography, stents

$285,000/yr
#5
Orthopedic Surgery

Joint replacements, fracture repair

$267,000/yr
#6
Gastroenterology

Colonoscopies, endoscopies

$243,000/yr
#7
Urology

Prostate procedures, kidney stone treatment

$228,000/yr
#8
Dermatology

Skin biopsies, Mohs surgery, biologics

$204,000/yr
#9
Nephrology

Dialysis management, kidney transplant follow-up

$195,000/yr
#10
Pulmonary Disease

Bronchoscopies, sleep studies, ventilator management

$178,000/yr

The pattern is clear: specialties that administer expensive drugs (ophthalmology, oncology) or perform high-cost procedures (cardiology, orthopedics) dominate the top. Meanwhile, primary care specialties that keep patients healthy — family practice ($78K), internal medicine ($95K), pediatrics ($42K) — earn a fraction as much.

Deep dive: The Specialty Pay Gap →

Why Ophthalmology Dominates

Ophthalmology's #1 position isn't about volume — it's about drugs. A single injection of Eylea (aflibercept) for macular degeneration can cost Medicare $1,800+. An active retina specialist might administer 20-30 injections per week. That's $36,000-$54,000 in drug costs alone, on top of the physician fee.

One eye injection drug — Eylea — costs Medicare approximately $19.7 billion per year, making it the single most expensive drug in the Part B program. The physicians who administer it are among the highest-paid in the system.

Read more: Eye Care Billions →

The Lab Corp & Quest Factor

Individual doctors aren't always the biggest Medicare earners. Clinical laboratories — particularly LabCorp and Quest Diagnostics — average $1.9 million per NPI. With just 37 National Provider Identifiers between them, these two companies collected approximately $14 billion from Medicare, representing about 25% of all clinical laboratory payments.

Read more: The LabCorp-Quest Duopoly →

When High Billing Becomes Suspicious

High Medicare billing isn't inherently wrong — busy specialists in high-cost fields legitimately earn large sums. But our machine learning fraud detection model, trained on 8,300+ confirmed fraud cases, found that billing amount is one of the strongest predictors of fraud risk.

Among the 500 providers flagged by our AI model, 47 each billed over $1 million, combining for $93 million in payments. Their billing patterns — extreme service volumes, unusual procedure mixes, statistical outliers in every dimension — match the profiles of convicted Medicare criminals.

Not every high earner is a fraudster. But when a solo internal medicine doctor in South Florida bills $12 million in a year — more than a busy surgical group — the math deserves scrutiny.

The Red Line

The average family doctor earns $55K from Medicare. The average internal medicine physician earns $95K. When an individual provider bills $5M+ — that's 50-90x the average — it doesn't necessarily mean fraud. But it means every one of those claims deserves a closer look.

See the 47 AI-flagged providers who billed over $1M each →

The Geographic Dimension

Where you practice matters almost as much as what specialty you practice. Providers in Florida average $121K in Medicare payments — far above the $49.7K national average. New Jersey, New York, and Texas also see above-average per-provider payments.

This isn't just cost-of-living. Florida has more Medicare beneficiaries per capita than any other state, an older population that uses more services, and — historically — the highest rate of Medicare fraud investigations in the country.

Full state-by-state cost breakdown →

How to Look Up Any Doctor's Medicare Earnings

All Medicare physician payment data is public. You can search any doctor's billing on OpenMedicare:

  • Search by provider name or NPI to see total payments, service counts, and specialty
  • Read our step-by-step lookup guide
  • Check the AI fraud watchlist to see if a provider has been flagged

Methodology

This analysis uses the CMS Medicare Physician and Other Supplier Public Use File for 2023. Average payments per specialty are calculated from total Medicare allowed amounts divided by unique NPIs per specialty. Top earner figures reference specific providers in the dataset. Fraud flags reference our supervised machine learning model (Random Forest, AUC 0.83) trained on LEIE exclusion data and DOJ prosecution records.

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.

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💰 Medicare's Biggest Billers🏥 The Specialty Monopoly⚠️ The Impossible Doctors💊 Follow the Drug Money
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