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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Procedures
  3. 99291
  4. Cost Analysis

How Much Does Critical care delivery critically ill or injured patient, first 30-74 minutes Cost on Medicare?

Cost analysis for CPT 99291 — Critical care delivery critically ill or injured patient, first 30-74 minutes

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Average Medicare Payment

$167.39

2023 data

Total Payments (2023)

$902.8M

Services (2023)

5.3M

Price Change (2014–2023)

-4.0%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2014$174.39$882.2M5.0M—
2015$175.53$894.1M5.0M+0.7%
2016$174.50$911.8M5.2M-0.6%
2017$176.76$955.0M5.4M+1.3%
2018$174.67$961.9M5.5M-1.2%
2019$175.18$992.9M5.6M+0.3%
2020$183.90$1.1B6.0M+5.0%
2021$183.67$1.1B5.8M-0.1%
2022$178.86$962.8M5.4M-2.6%
2023$167.39$902.8M5.3M-6.4%

🗺️ State-by-State Cost Variation

The most expensive state pays 1.4x more than the cheapest for this procedure. AK averages $218.84 vs NE at $154.51.

StateAvg PaymentTotal PaymentsServicesProviders
AK$218.84$1.5M7.0K110
NY$186.22$71.0M381.0K4.7K
DC$180.08$6.0M33.2K405
NJ$178.87$31.6M176.6K2.0K
AP$178.67$69.1K3875
XX$178.07$31.7K1781
CA$176.49$134.5M761.9K7.2K
MD$176.24$25.2M142.7K1.6K
CT$174.83$12.0M68.5K1.1K
IL$174.36$39.4M226.1K2.9K
MA$173.65$27.6M159.0K2.1K
RI$172.30$3.1M17.8K297
FL$171.66$74.9M436.4K4.8K
DE$171.66$2.6M15.1K238
PR$169.70$618.0K3.6K69
AE$169.05$44.8K2657
PA$168.71$44.5M264.0K3.8K
WA$168.71$13.1M77.6K1.4K
MI$168.62$27.3M161.9K2.7K
CO$167.35$12.0M72.0K1.2K
NV$166.93$8.4M50.1K592
VA$166.75$23.8M142.6K1.9K
HI$166.34$2.9M17.2K275
ME$165.98$2.2M13.5K284
GU$165.73$169.9K1.0K13
LA$165.19$11.0M66.4K1.0K
AZ$164.58$15.7M95.2K1.2K
MT$164.38$1.9M11.8K200
TX$164.36$64.4M392.0K4.7K
NM$164.24$3.2M19.6K341
OH$164.10$32.1M195.4K3.1K
OR$163.84$6.3M38.5K737
WV$163.84$4.1M25.1K420
VI$163.75$37.7K2304
NH$163.74$3.0M18.2K317
ND$163.23$1.8M11.3K143
WY$163.10$538.5K3.3K70
ZZ$163.06$71.4K4387
VT$162.48$1.1M6.9K119
SD$162.44$1.3M8.0K99
GA$162.01$22.9M141.4K2.2K
MN$161.72$8.6M53.0K1.1K
MO$161.46$16.8M103.8K1.5K
KY$161.43$12.7M78.6K1.0K
UT$161.01$3.5M22.0K454
NC$160.12$24.5M152.8K2.6K
SC$159.96$11.5M72.2K1.2K
OK$159.32$9.1M57.4K777
MS$159.22$8.0M50.5K604
IN$158.48$14.3M90.5K1.4K
WI$158.16$10.0M63.4K1.2K

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Abdulkareem SharafCardiologyCA$725.1K4.1K$176.63
Pankaj ShahInternal MedicineTX$379.0K2.3K$163.03
Alaa AfifiCardiac SurgeryCA$375.1K2.1K$176.60
Zahra TabassianInternal MedicineCA$369.6K2.1K$176.75
Farid GheblehPulmonary DiseaseAZ$347.0K2.1K$164.40
Omer DeenInternal MedicineCA$341.9K2.0K$175.05
Vipin GargCritical Care (Intensivists)NJ$332.8K1.8K$180.57
Muhammad RazaCritical Care (Intensivists)AZ$330.5K2.0K$163.62
Mehmet DemirozuInternal MedicineCA$326.7K1.9K$171.85
George ShahinianPulmonary DiseaseCA$303.2K1.7K$176.30
Ashok MittalPulmonary DiseaseFL$295.9K1.7K$173.47
Rosy JosephNephrologyNJ$286.6K1.7K$172.16
Tuan NguyenCardiologyCA$278.1K1.6K$176.55
Bijan MoradiInternal MedicineFL$278.0K1.6K$173.76
Richard TranInternal MedicineCA$273.8K1.6K$174.29
Anthony SalehPulmonary DiseaseNY$263.5K1.3K$195.88
Jeffry JonesInternal MedicineCA$257.4K1.5K$175.45
Rajiv PhilipPulmonary DiseaseCA$256.8K1.5K$176.61
Reza TehraniInternal MedicineMI$248.4K1.5K$164.26
Frida PopilevskyPulmonary DiseaseNY$247.0K1.3K$195.72

🤔 Is Critical care delivery critically ill or injured patient, first 30-74 minutes Overpriced?

Based on the data, CPT 99291 shows a 1.4x variation in pricing across states — relatively consistent by Medicare standards.

Costs have decreased 4% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.

This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

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