Medicare provider payments and utilization data for California (CA)
California received $93.2B in total Medicare provider payments across 10 years of data.
The top specialty by spending is Clinical Laboratory, accounting for $1.6B in payments across 336 providers.
In 2023, 93.5K providers were actively billing Medicare in California.
Annual Medicare spending grew 43% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Providers in this state flagged by the ML v2 fraud detection model
| Year | Payments | Services | Providers | YoY Change |
|---|---|---|---|---|
| 2014 | $8.1B | 206.9M | 75.0K | — |
| 2015 | $8.3B | 214.8M | 76.9K | +3.3% |
| 2016 | $8.4B | 216.5M | 79.5K | +0.5% |
| 2017 | $8.7B | 237.6M | 81.8K | +3.3% |
| 2018 | $9.0B | 246.4M | 83.9K | +3.9% |
| 2019 | $9.4B | 251.9M | 85.8K | +4.8% |
| 2020 | $8.8B | 233.3M | 84.4K | -7.1% |
| 2021 | $10.3B | 247.2M | 87.4K | +18.1% |
| 2022 | $10.7B | 255.1M | 90.4K | +3.2% |
| 2023 | $11.5B | 268.1M | 93.5K | +8.0% |
| Code | Description | Payments | Services | Providers |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | $880.4M | 9.4M | 38.0K |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | $457.9M | 6.9M | 34.7K |
| 81479 | Molecular pathology procedure | $315.6M | 137.8K | 19 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $302.1M | 3.1M | 11.5K |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | $220.6M | 1.7M | 15.4K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $205.5M | 454.7K | 206 |
| J0178 | Injection, aflibercept, 1 mg | $200.6M | 291.7K | 310 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $199.9M | 3.1M | 12.3K |
| 93229 | Electrocardiogram (ecg) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional | $164.1M | 184.7K | 350 |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | $163.3M | 14.1M | 2.8K |
| 66984 | Removal of cataract with insertion of prosthetic lens | $153.9M | 222.0K | 1.3K |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $149.0M | 1.1M | 13.2K |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | $139.4M | 1.1M | 19.4K |
| 99291 | Critical care, first 30-74 minutes | $134.5M | 761.9K | 7.2K |
| Q4236 | Carepatch, per square centimeter | $117.6M | 122.1K | 19 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $114.8M | 5.9M | 6.7K |
| 99285 | Emergency department visit with high level of medical decision making | $105.6M | 755.0K | 5.3K |
| 0242U | Gene analysis of 55-74 genes associated with solid organ cancer in cell-free circulating dna, targeted genomic sequence analysis panel | $104.7M | 21.4K | 1 |
| 97530 | Therapy procedure using functional activities | $99.9M | 3.7M | 5.2K |
| 81519 | Test for detecting genes associated with breast cancer | $94.7M | 25.0K | 1 |
| Specialty | Payments | Providers | Avg per Provider |
|---|---|---|---|
| Clinical Laboratory | $1.6B | 336 | $4.7M |
| Internal Medicine | $941.1M | 9.2K | $102.4K |
| Ophthalmology | $774.7M | 2.0K | $396.3K |
| Cardiology | $526.4M | 1.8K | $290.2K |
| Ambulatory Surgical Center | $469.5M | 631 | $744.1K |
| Family Practice | $455.9M | 7.0K | $65.3K |
| Diagnostic Radiology | $434.5M | 3.2K | $135.5K |
| Ambulance Service Provider | $410.4M | 259 | $1.6M |
| Dermatology | $402.6M | 1.4K | $282.5K |
| Physical Therapist in Private Practice | $387.2M | 6.6K | $58.8K |
| Independent Diagnostic Testing Facility (IDTF) | $352.3M | 245 | $1.4M |
| Hematology-Oncology | $326.9M | 879 | $371.9K |
| Nurse Practitioner | $319.8M | 7.1K | $44.8K |
| Physician Assistant | $219.4M | 5.8K | $38.0K |
| Orthopedic Surgery | $208.6M | 1.8K | $115.3K |
| Emergency Medicine | $204.0M | 4.9K | $42.0K |
| Podiatry | $194.8M | 1.4K | $135.5K |
| Mass Immunizer Roster Biller | $175.2M | 2.5K | $70.0K |
| Nephrology | $174.4M | 921 | $189.4K |
| Neurology | $154.9M | 1.5K | $102.3K |
| Rheumatology | $151.8M | 489 | $310.5K |
| Radiation Oncology | $151.3M | 457 | $331.0K |
| Urology | $141.8M | 795 | $178.4K |
| Pulmonary Disease | $120.8M | 884 | $136.6K |
| Gastroenterology | $118.2M | 1.3K | $92.3K |
Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.