South Carolina Medicare Revenue Analysis

CMS Medicare Physician & Other Practitioners data

South Carolina has 19K Medicare providers who collectively received $1708.0M in Medicare payments, averaging $90K per provider. South Carolina providers earn moderate Medicare revenue per provider, with significant opportunity to capture additional revenue through program enrollment and coding optimization.

The most common specialty is Nurse Practitioner with 3,274 providers, followed by Physician Assistant (1,565) and Family Practice (1,454). Nurse Practitioner providers in South Carolina average $42K annually, with room to grow through CCM, RPM, and AWV program adoption.

The largest Medicare provider concentration is in Greenville (2,847 providers), with Charleston and Columbia also serving as major healthcare hubs. Practices in these areas face competitive pressure, making revenue optimization through proper coding and program enrollment critical for financial performance.

Data: CMS Medicare Physician & Other Practitioners, 2024Coverage: 18,943 providers analyzedLast updated: January 2026

Total Providers

19K

in South Carolina

Total Medicare Payment

$1708.0M

Avg Payment / Provider

$90K

Total Services

50.6M

South Carolina Performance Signals

Revenue per Provider

$90,165

+13.1% vs benchmark · national avg $79,744

Provider Market Share

1.6% of US

-19.4% vs benchmark · 18,943 providers

CCM Adoption

3.4%

-69.7% vs benchmark · national 11.3%

RPM Adoption

0.7%

-88.5% vs benchmark · national 6.5%

AWV Completion

10.0%

-42.7% vs benchmark · national 17.5%

Key Stats

19K
Total Providers(South Carolina)
$90K
Avg Medicare Payment(per provider)
$1708.0M
Total Medicare Payments
Nurse Practitioner
Top Specialty(3,274 providers)

How This Compares

#12 of 62
National rank by avg Medicare payment
+13%vs national average
South Carolina Medicare Revenue

Top Opportunities

#1
Chronic Care Management (99490)
$17.7M potential
#2
Remote Patient Monitoring (99454)
$14.5M potential
#3
Annual Wellness Visits (G0438/G0439)
$8.4M potential
Peer group: 18,943 providers
Confidence: High
CMS Medicare Public Data 2024
Data year: 2024

How South Carolina Compares

#12
of 62 states
+13%
vs national avg

vs Neighboring States

South Carolina
$90K
Georgia
$70K
-23%
North Carolina
$67K
-26%
Strongest Specialty
Nurse Practitioner
3,274 providers
Biggest Program Gap
CCM (99490)
3.4% adoption vs 11.3% national

Top Revenue Opportunities in South Carolina

#1

Chronic Care Management (99490)

$17.7M
estimated annual opportunity

Only 3.4% of providers bill CCM vs 11.3% national average. 1,487 additional providers could adopt CCM to close this gap.

Current: 3.4%Target: 11.3%
high confidence· 1,487 providers
#2

Remote Patient Monitoring (99454)

$14.5M
estimated annual opportunity

RPM adoption is 0.7% vs 6.5% nationally. 1,084 providers could implement RPM programs.

Current: 0.7%Target: 6.5%
high confidence· 1,084 providers
#3

Annual Wellness Visits (G0438/G0439)

$8.4M
estimated annual opportunity

AWV completion at 10.0% trails the 17.5% national average. 1,414 additional providers could offer AWV services.

Current: 10.0%Target: 17.5%
high confidence· 1,414 providers

Market Opportunities by Specialty

Top 50 Providers in South Carolina

ProviderPatientsMedicare $
Eric JablonM.D.1,454$8.9M
Medshore Ambulance Service, Llc9,909$6.4M
Robert PrinziMD1,168$5.7M
Medtrust Medical Transport, Llc9,996$5.3M
Stephen PhillipsM.D.801$5.0M
John KerrisonM.D.1,219$5.0M
Derek BarkerM.D.1,528$4.7M
Prisma Health-Upstate7,218$4.5M
County Of Greenville6,392$4.2M
Charleston County Government6,330$4.1M
Nicholas MarchaseM.D.702$4.1M
John PayneMD768$4.0M
Steven MaddenMD866$4.0M
Horry County Government6,741$4.0M
The Southeastern Spine Institute Ambulatory Surgery Center, Llc1,360$4.0M
County Council For Richland County5,589$4.0M
John WellsMD885$3.9M
Physicians Eye Surgery Center Llc1,569$3.9M
Stephen ParksMD293$3.9M
Charles ButlerM.D.854$3.8M
Outpatient Surgery Center Of Hilton Head740$3.7M
Lindsay GambleAPRN, FNP-C557$3.7M
Daniel AlfaroM.D.1,010$3.6M
Center For Advanced Surgery Llc1,197$3.6M
Brandon CoakleyMD954$3.5M
Aaron FlandersMD878$3.5M
Parkway Surgery Center596$3.5M
Columbia Eye Surg Center Inc1,785$3.5M
Midlands Orthopaedics Surgery Center, Llc634$3.5M
Vijaya KorrapatiM.D.673$3.4M
Lisa SaulsAPRN433$3.4M
Suhail KumarMD470$3.4M
Jill SullivanM.D.549$3.4M
Perrie RyanM.D.629$3.3M
Christopher MichaelisD.O.225$3.3M
William ClarkMD722$3.3M
Greenville Surgery Center Lp1,413$3.3M
Barron FishburneM.D.714$3.3M
Long Huynh-DucD.O.533$3.2M
Asheesh LalM.D.691$3.2M
James WellsM.D.716$3.2M
Adam PflugrathMD843$3.1M
Jordan HendersonD.O.911$3.1M
John RenfroMD1,074$3.1M
First Priority Inc5,003$3.1M
Taylor MaderM.D.423$3.1M
Carolina Regional Surgery Center. Ltd1,463$3.0M
Jeffrey GrossM.D.443$3.0M
Michael JohnsonM.D.1,002$3.0M
David JohnsonMD778$3.0M

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