Virginia Medicare Revenue Analysis

CMS Medicare Physician & Other Practitioners data

Virginia has 30K Medicare providers who collectively received $2523.7M in Medicare payments, averaging $84K per provider. Virginia 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 4,635 providers, followed by Physician Assistant (2,672) and Family Practice (2,103). Nurse Practitioner providers in Virginia average $29K annually, with room to grow through CCM, RPM, and AWV program adoption.

The largest Medicare provider concentration is in Richmond (2,990 providers), with Charlottesville and Virginia Beach 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: 29,945 providers analyzedLast updated: January 2026

Total Providers

30K

in Virginia

Total Medicare Payment

$2523.7M

Avg Payment / Provider

$84K

Total Services

73.7M

Virginia Performance Signals

Revenue per Provider

$84,278

+5.7% vs benchmark · national avg $79,744

Provider Market Share

2.5% of US

+27.4% vs benchmark · 29,945 providers

CCM Adoption

1.7%

-84.8% vs benchmark · national 11.3%

RPM Adoption

0.7%

-89.3% vs benchmark · national 6.5%

AWV Completion

9.9%

-43.1% vs benchmark · national 17.5%

Key Stats

30K
Total Providers(Virginia)
$84K
Avg Medicare Payment(per provider)
$2523.7M
Total Medicare Payments
Nurse Practitioner
Top Specialty(4,635 providers)

How This Compares

#17 of 62
National rank by avg Medicare payment
+6%vs national average
Virginia Medicare Revenue

Top Opportunities

#1
Chronic Care Management (99490)
$34.0M potential
#2
Remote Patient Monitoring (99454)
$23.1M potential
#3
Annual Wellness Visits (G0438/G0439)
$13.4M potential
Peer group: 29,945 providers
Confidence: High
CMS Medicare Public Data 2024
Data year: 2024

How Virginia Compares

#17
of 62 states
+6%
vs national avg

vs Neighboring States

Virginia
$84K
Kentucky
$56K
-33%
Maryland
$111K
+32%
North Carolina
$67K
-21%
Tennessee
$74K
-13%
Strongest Specialty
Nurse Practitioner
4,635 providers
Biggest Program Gap
CCM (99490)
1.7% adoption vs 11.3% national

Top Revenue Opportunities in Virginia

#1

Chronic Care Management (99490)

$34.0M
estimated annual opportunity

Only 1.7% of providers bill CCM vs 11.3% national average. 2,861 additional providers could adopt CCM to close this gap.

Current: 1.7%Target: 11.3%
high confidence· 2,861 providers
#2

Remote Patient Monitoring (99454)

$23.1M
estimated annual opportunity

RPM adoption is 0.7% vs 6.5% nationally. 1,729 providers could implement RPM programs.

Current: 0.7%Target: 6.5%
high confidence· 1,729 providers
#3

Annual Wellness Visits (G0438/G0439)

$13.4M
estimated annual opportunity

AWV completion at 9.9% trails the 17.5% national average. 2,256 additional providers could offer AWV services.

Current: 9.9%Target: 17.5%
high confidence· 2,256 providers

Market Opportunities by Specialty

Top 50 Providers in Virginia

ProviderPatientsMedicare $
Robert BrennanMD1,356$15.9M
Sentara Reference Lab Solutions, Llc78,934$12.9M
Roanoke Valley Center For Sight Llc3,108$8.4M
Director Of Finance-County Of Fairfax Va10,927$7.9M
Berger And Burrow Enterprises Inc.21,877$6.6M
Inova Health Care Services35,736$5.4M
Rca Laboratory Services, Llc5,633$5.3M
American Medical Response Mid-Atlantic, Inc.9,589$4.9M
Gordon ByrnesM.D.1,452$4.9M
Med Atlantic Inc790$4.9M
Stony Point Surgery Center, L.L.C2,118$4.9M
Virginia Surgery Center, Llc2,390$4.8M
John O'keefeM.D.1,273$4.8M
Virginia Eye Institute Inc2,120$4.8M
Timothy ByrnesMD1,132$4.7M
Juan AstrucM.D.1,018$4.7M
Matthew ReedMD1,124$4.6M
Mohit NandaMD1,227$4.6M
David CarletonMD629$4.3M
Microgen Health, Inc2,956$4.3M
Vista Clinical Diagnostics Llc10,684$4.3M
Phong NguyenMD992$4.2M
Alexander MelamudMD1,345$4.2M
Jordana FeinM.D., M.S.1,006$4.2M
Sundeep KasiM.D.1,255$4.1M
Rohit AdyanthayaMD1,150$4.1M
Victor ArchieMD161$4.0M
David JacobsMD1,197$4.0M
Surgery Center Of Lynchburg Llc767$4.0M
Quest Diagnostics Clinical Laboratories Inc32,583$3.9M
Mark FlemingMD716$3.9M
Healthqare Services Asc Llc413$3.9M
Jacob MeyerMD1,025$3.8M
James SimsarianM.D.308$3.8M
Byron LaddM.D.1,425$3.8M
Alan WagnerMD2,524$3.8M
Christopher SinesiM.D.251$3.8M
Elena FlaggM.D.445$3.8M
Chesapeake Regional Surgery Center At Virginia Beach, Llc450$3.7M
Adam LipmanMD1,082$3.7M
Bryan SchwentM.D.807$3.7M
Thomas JohnsonM.D.1,618$3.6M
Kapil KapoorMD2,428$3.6M
Thomas AlbericoMD946$3.5M
Alex PavidaphaM.D276$3.5M
Allan ThorntonM.D.250$3.3M
Ryan DeasyMD916$3.3M
Barry MandellMD975$3.3M
Central Virginia Surgi-Center Lp1,254$3.2M
Laila RahbarMD437$3.2M

Scan a Provider in Virginia

Scan a Provider in Virginia

Enter an NPI number for any Medicare provider in Virginia to instantly see missed revenue opportunities.

Run Free Scan