Medical Expenditure Panel Survey Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #166 

March 2007 

Expenses for Office-Based Physician 

Visits by Specialty, 2004 

Steven R. Machlin, MS and Kelly Carper, MEd 

Introduction 

In recent years, an important health policy issue with implications for 

both cost and quality of care has been the use of primary care 

physicians versus specialists. This Statistical Brief presents data 

from the Household Component of the Medical Expenditure Panel

Survey (MEPS-HC) on expenses by provider specialty type for 

office-based physician visits in 2004 among persons in the U.S. 

civilian noninstitutionalized population. Data are shown for the eight 

most common types of office-based physician specialties, including 

1) primary care (defined in this brief as general practice, family 

practice, and internal medicine); 2) pediatrics; 3) obstetrics/gynecology; 4) ophthalmology; 5) orthopedics; 6) psychiatry; 7) cardiology; and 8) dermatology; as well as a ninth catchall category that 

includes all other physician specialty types. Descriptive data on 

aggregate expenses, expenses per visit, and out-of-pocket payments

for these physician specialty categories are presented. All differences 

between estimates noted in the text are statistically significant at the 

0.05 level or better. 

Findings 

Sources of payment 

In 2004, office visits to physicians accounted for about 16 percent of

total health care expenses for the civilian noninstitutionalized 

population (figure 1). Private insurance paid for nearly half (48.3 

percent) and Medicare paid for just over one-fifth (21.1 percent) 

of all expenditures for these visits. Out-of-pocket payments by 

individuals and families was the third largest source of payment 

category, comprising 14.1 percent of total expenditures for officebased physician care. 

Distribution of visits and expenses 

While more than one-third of visits for office-based physician care 

(37.2 percent) were to primary care doctors in general practice, 

family practice, or internal medicine, only about one-quarter of 

expenditures were for visits to these types of physicians (figure 2). 

Expenditures for visits to pediatricians also comprised a disproportionately low share of total expenditures 

for office-based physician care (9.2 percent of visits versus 5.8 percent of expenses). These discrepancies reflect the fact that visits to these types of physicians are generally less expensive than visits to 

many other types of physicians (e.g., ophthalmologists, orthopedists, cardiologists, and specialists 

included in the “other” category, such as neurologists, urologists, and general surgeons). 

Highlights 

 In 2004, office visits to 

physicians accounted for 

about 16 percent of total 

health care expenses for the 

civilian noninstitutionalized 

population. Private insurance 

paid for nearly half of all 

expenses for these visits. 

 While almost half of visits for 

office-based physician care 

were to doctors in general 

practice, family practice, 

internal medicine, or pediatrics, less than one-third of 

aggregate expenditures were 

for visits to these types of 

physicians.

 Overall, the average expenditure for an office-based 

physician visit was $155 

while the median per visit 

expenditure was $72. Among 

the specialty types examined, 

average expenses per visit 

were lowest for primary care 

providers, pediatricians, and 

psychiatrists, and were highest (at least twice as large) 

for ophthalmologists, orthopedists, and cardiologists. 

 In 2004, the average share 

of expenses paid out of 

pocket for a physician visit 

was lowest for visits to cardiologists and orthopedists 

and highest for visits to ophthalmologists, psychiatrists, 

and dermatologists.
Average expenses per visit 

In 2004, the average expense for an office-based visit to a physician was $155 (figure 3). However, the 

average expense per visit varied substantially according to physician specialty. For example, the 

averages for primary care providers (general practitioners, family practitioners, internists), pediatricians, 

and psychiatrists were about $100, which was about half or less of the average expense for a visit to a 

cardiologist ($232), orthopedist ($210), or ophthalmologist ($206). 

Median expenses per visit 

In 2004, the median expense for an office-based visit to a physician was $72 (figure 4), which was less 

than half the overall average expense per physician visit of $155 (figure 3). The median expense per visit 

was substantially lower than the average because the most expensive visits have a disproportionate 

impact on the average. 

Among the specialty types examined, median expenses per visit ranged from $64 for the category of 

general practitioners, family practitioners, and internists to $88 for orthopedists (figure 4). Although the 

median expense was markedly lower than the average expense (figure 3) for each physician specialty 

group examined, there was less variation across physician specialty groups in median than in average 

expenses. 

Out-of-pocket payments 

On average, in 2004 about one-fifth of expenses for an office-based physician visit were paid out of 

pocket (19.4 percent) (figure 5), but this percentage varied by physician specialty. The average share 

paid out of pocket was lowest for visits to cardiologists (12.9 percent) and orthopedists (15.7 percent) and 

highest for visits to ophthalmologists, psychiatrists, and dermatologists (about one-quarter of expenses 

for these providers, on average). 

Data Source 

The estimates in this Statistical Brief are based upon data from the MEPS 2004 Full Year Consolidated 

File (HC-089) and Office-Based Medical Provider Visits data files (HC-085G). 

Definitions 

Expenses/expenditures

Payments from all sources for office-based visits to a physician reported by respondents in the MEPSHC. Sources include direct payments from individuals, private insurance, Medicare, Medicaid, Workers’ 

Compensation, and miscellaneous other sources. 

Type of specialist 

MEPS respondents who reported an office-based visit in which a medical doctor was seen were asked to 

identify the doctor’s specialty (the questionnaire contains 34 response categories for coding the specialty 

type reported). In this Statistical Brief, the categories for general practice, family practice, and internal 

medicine (internist) were combined because it may be difficult for respondents to distinguish between 

these types of primary care physicians (pediatricians were kept as a separate category). Multiple types of 

physician specialties were combined into the catchall “other” category shown in this brief, including 

allergy/immunology, anesthesiology, endocrinology/metabolism, gastroenterology, general surgery, 

geriatrics, hematology, hospital residence, nephrology, nuclear medicine, oncology, osteopathy, 

otorhinolaryngology (ear, nose, throat), pathology, physical medicine/rehab, plastic surgery, proctology, 

pulmonary, radiology, rheumatology, thoracic surgery, urology, and other doctor specialty. While each of 

the specialist types within this category comprised less than 2 percent of physician visits, they 

cumulatively comprised approximately one-quarter of all visits. A small proportion of visits in which a 

medical doctor was seen (1.6 percent) were excluded from the analysis because specialty type was not 

reported. 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. 
For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care,

July 2003: 41(7) Supplement: III-5–III-12. 

Suggested Citation 

Machlin, S. R. and Carper K. Expenses for Office-Based Physician Visits by Specialty, 2004. Statistical 

Brief #166. March 2007. Agency for Healthcare Research and Quality, Rockville, Md. http://www.meps. 

ahrq.gov/mepsweb/data_files/publications/st166/stat166.pdf 

∗ ∗ ∗

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepspd@ahrq.gov or send a letter to the address below: 

Steven B. Cohen, PhD, Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2004

Figure 1. Expenditures for office-based physician visits, 2004

Private insurance: 48.3%

Medicare: 21.1%

Out-of-pocket: 14.1%

Medicaid: 7.0%

Other: 9.5%

All expenses

($963.9 billion)

Office physician visits

sources of payment

Other

ambulatory

care: 19.7%

Prescribed

medicines

19.8%

Other

13.2%

Office

physician

visits:15.9%

Inpatient

31.4%

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2004

37.2%

24.4%

7.6% 9.2%

5.1%

4.1%

3.3%

2.9%

6.1%

Figure 2. Distribution of office-based physician visits 

and expenditures, by specialty type, 2004

37.1%

7.0%

2.6%

2.7%

5.0%

24.2%

7.5% 5.8%

8.2%

General/Family Practice, Internal Med.

Obstetrics and Gynecology

Psychiatry

Other

Ophthalmology

Cardiology

Pediatrics

Orthopedics

Dermatology

Visits Expenditures

Statistical Brief #166: Expenses for Office-Based Physician Visits by Specialty, 2004 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2004

Figure 3. Mean expenses per office-based 

physician visit, by specialty type, 2004

155

101 98

153

206 210

95

232

142

235

0

50

100

150

200

250

Overall General/Family

Practice,

Internal Med.

 Pediatrics Obstetrics 

and

Gynecology

Ophthalmology Orthopedics Psychiatry Cardiology Dermatology Other

D

ollars

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2004

Figure 4. Median expenses per office-based 

physician visit, by specialty type, 2004

72

64

70

84 86 88

72

83 80 82

0

25

50

75

100

125

Overall General/Family

Practice,

Internal Med.

 Pediatrics Obstetrics

and

Gynecology

Ophthalmology Orthopedics Psychiatry Cardiology Dermatology Other

D

ollars

Statistical Brief #166: Expenses for Office-Based Physician Visits by Specialty, 2004 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2004

Figure 5. Average percentage paid out of pocket for 

office-based physician visits, by specialty type, 2004

19.4 20.1

18.0 18.0

25.2

15.7

24.8

12.9

25.7

17.8

0

5

10

15

20

25

30

Overall General/Family

Practice,

Internal Med.

 Pediatrics Obstetrics 

and

Gynecology

Ophthalmology Orthopedics Psychiatry Cardiology Dermatology Other

Percent

Note: Estimates exclude small number of visits where no payment was made.

Statistical Brief #166: Expenses for Office-Based Physician Visits by Specialty, 2004