Medicare's Most Expensive Doctors

Published February 2026 · 12 min read

Of the 1,000 highest-billing Medicare providers in our database, 455 are classified as individuals and 545 are organizations. But among those individuals, a striking pattern emerges: many of the very highest billers have their names and specialties redacted for privacy, making it impossible to determine exactly who is receiving hundreds of millions in taxpayer dollars.

Among the providers we can identify, the specialties that dominate tell a story about where Medicare money flows — and it's not always where you'd expect.

The Redaction Problem: Who's Hiding?

The single highest-billing individual in our dataset received $269.1M from Medicare over the analysis period — but their name, specialty, and state are all listed as "Unknown." CMS redacts provider information in certain cases to protect patient privacy (when a provider has very few patients with a specific condition) or when data aggregation could enable re-identification.

At least 10 of the top 20 individual billers have their identities redacted. These providers collectively received over $1.5B in Medicare payments, and the public has no way to know who they are or what services they provide.

The Top Named Individual Providers

When we filter to only named individuals — those whose identity CMS has not redacted — the list reveals the specialties that drive the highest individual Medicare billings.

Which Specialties Dominate the Top Earners?

Among identifiable top individual billers, ophthalmology is the clear leader. Eye doctors who perform high-volume cataract surgeries and administer expensive retinal injections like aflibercept ($19.7B total across Medicare) can easily accumulate $50–100 million in Medicare payments over a decade.

The presence of nurse practitioners at the very top of the individual billing list is more surprising. The two highest-named billers are both NPs in Arizona, each collecting over $120.0M. This likely reflects high-volume practices, possibly in pain management or diagnostic testing, where the NP serves as the billing provider for large clinical operations.

Geographic Concentration

Among named top-billing individuals, geographic patterns emerge. Arizona appears disproportionately, with three of the top five named providers practicing there. Florida — home to a massive Medicare population — is also heavily represented, particularly among ophthalmologists.

This mirrors the broader state spending picture: California leads all states with$93.2B in total Medicare payments, followed by Florida at $80.4B and Texas at $62.9B. States with large elderly populations naturally generate more Medicare billing, but the concentration of top individual earners in specific states suggests that practice patterns and local market conditions matter enormously.

The 1% vs. Everyone Else

The concentration of Medicare payments is staggering. The average Medicare provider received about $79.7K per year in 2023 (based on $93.7B total payments across 1.2M providers). That's $797.0K over a decade.

Meanwhile, the top individual provider collected $135.3M over the same period — 170 times the average provider. Even the 100th-ranked individual provider received more than 50 times the average.

Why This Matters

High individual billing isn't automatically problematic. An ophthalmologist who performs thousands of cataract surgeries per year is providing a valuable, high-volume service. A nurse practitioner overseeing a large clinical operation may be the billing provider for an entire facility's worth of care.

But the extreme concentration of payments — combined with widespread identity redaction — raises important oversight questions. When a single individual receives over a quarter billion dollars from Medicare and the public can't even know their name, the system's transparency has failed.

Medicare's Office of Inspector General regularly investigates high-billing providers for potential fraud. But the sheer volume of billing — $93.7B in 2023 alone — means that outlier detection is the first line of defense. Understanding who the biggest billers are, and why they bill so much, is essential to ensuring taxpayer dollars are well spent.

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