Hospitalists in South Dakota · Original Medicare · 2024
A sepsis admission with a major complication in South Dakota pays the hospital about $14,869. The fees for the hospitalist’s six visits on it come to about $445.
That’s about 3 cents on the dollar. The hospital’s payment is one sum per admission, set mostly by the DRG and the hospital’s own rate. The DRG depends on what the chart documents. The visits are paid as one fee each. Here’s how that looks across South Dakota’s commonest admissions, and how Medicare’s payment per service has moved since 2018.
One admission: the hospital’s payment and the visit fees
The hospital’s number below is Medicare’s own: its average payment per stay to South Dakota hospitals in 2024. The visit figure is ours: one hospitalist’s admission, daily visits and discharge on that stay, at the codes South Dakota hospitalists bill most, each priced at Medicare’s average 2024 payment for it when a South Dakota hospitalist billed it. Pick the admission you did last night.
Septicemia or severe sepsis without MV >96 hours with MCC
MS-DRG 871Hospital: about $14,869. Fees for the hospitalist’s visits: about $445. 3 cents on the dollar.
Hospital: Medicare’s average payment per stay over 1,761 discharges at 10 South Dakota hospitals. Visits: one physician billing the admission (99223, $128.07) on day 1, a daily visit (99232, $58.09) on each of the 4 days between, and the discharge (99239, $84.98) on day 6: 6 visit days over a 5-night stay.
Heart failure and shock with MCC
MS-DRG 291Hospital: about $9,354. Fees for the hospitalist’s visits: about $387. 4 cents on the dollar.
Hospital: Medicare’s average payment per stay over 888 discharges at 11 South Dakota hospitals. Visits: one physician billing the admission (99223, $128.07) on day 1, a daily visit (99232, $58.09) on each of the 3 days between, and the discharge (99239, $84.98) on day 5: 5 visit days over a 4-night stay.
Pulmonary edema and respiratory failure
MS-DRG 189Hospital: about $9,325. Fees for the hospitalist’s visits: about $387. 4 cents on the dollar.
Hospital: Medicare’s average payment per stay over 502 discharges at 10 South Dakota hospitals. Visits: one physician billing the admission (99223, $128.07) on day 1, a daily visit (99232, $58.09) on each of the 3 days between, and the discharge (99239, $84.98) on day 5: 5 visit days over a 4-night stay.
Simple pneumonia and pleurisy with MCC
MS-DRG 193Hospital: about $9,665. Fees for the hospitalist’s visits: about $387. 4 cents on the dollar.
Hospital: Medicare’s average payment per stay over 482 discharges at 9 South Dakota hospitals. Visits: one physician billing the admission (99223, $128.07) on day 1, a daily visit (99232, $58.09) on each of the 3 days between, and the discharge (99239, $84.98) on day 5: 5 visit days over a 4-night stay.
Respiratory infections and inflammations with MCC
MS-DRG 177Hospital: about $12,483. Fees for the hospitalist’s visits: about $445. 4 cents on the dollar.
Hospital: Medicare’s average payment per stay over 466 discharges at 8 South Dakota hospitals. Visits: one physician billing the admission (99223, $128.07) on day 1, a daily visit (99232, $58.09) on each of the 4 days between, and the discharge (99239, $84.98) on day 6: 6 visit days over a 5-night stay.
Hospital payments are calendar 2024. Nights are each DRG’s geometric mean length of stay in the FY 2025 IPPS final rule, rounded to whole nights. Every figure here is Medicare’s share and leaves out the patient’s part.
The hospital’s payment covers the whole stay: nurses, beds, pharmacy, imaging, the building. The visit fees cover the doctor’s work on those visits. The visit figure is one physician’s visits at the codes South Dakota hospitalists bill most, so it’s a model, and the fees on any one real stay differ.
Medicare’s payment per service, 2018 to 2024
In 2024 dollars, Medicare’s payment per service billed by the median South Dakota hospitalist was about $91 in 2018 and about $73 in 2024: 20% less per service. The median hospitalist also billed Original Medicare fewer services: 1,010 then, 696 now. These files hold Original Medicare only, no Medicare Advantage, and they counted 44 South Dakota hospitalists in 2018 and 76 in 2024. For a year of one South Dakota hospitalist’s services, the median Medicare payment went from about $85,347 to about $44,804 in 2024 dollars. Follow the same 35 doctors who are in every year’s file and it’s the same story: about $83,168 then, about $42,812 now, in 2024 dollars.
CMS created the hospitalist specialty code on 1 April 2017, so the series starts at 2018.
| Year | Hospitalists | Median services | Median payment | In 2024 dollars | Payment per service (2024 dollars) |
|---|---|---|---|---|---|
| 2018 | 44 | 1,010 | $68,320 | $85,347 | $91 |
| 2019 | 45 | 968 | $69,529 | $85,312 | $97 |
| 2020 note a | 54 | 814 | $55,644 | $67,443 | $90 |
| 2021 note a | 60 | 785 | $52,671 | $60,974 | $83 |
| 2022 | 64 | 710 | $45,486 | $48,755 | $76 |
| 2023 note b | 70 | 760 | $52,412 | $53,958 | $78 |
| 2024 | 76 | 696 | $44,804 | $44,804 | $73 |
| Year | Hospitalists | Median services | Median payment | In 2024 dollars | Payment per service (2024 dollars) |
|---|---|---|---|---|---|
| 2018 | 35 | 1,003 | $66,575 | $83,168 | $92 |
| 2019 | 35 | 968 | $67,888 | $83,298 | $91 |
| 2020 note a | 35 | 897 | $60,737 | $73,616 | $88 |
| 2021 note a | 35 | 791 | $52,668 | $60,971 | $83 |
| 2022 | 35 | 784 | $49,100 | $52,629 | $76 |
| 2023 note b | 35 | 739 | $49,179 | $50,629 | $79 |
| 2024 | 35 | 676 | $42,812 | $42,812 | $74 |
a 2020 and 2021: pandemic years.
b 2023: CMS revised the inpatient and observation E/M codes on 1 January 2023.
Nominal and 2024 dollars.
Purchasing power: BLS CPI-U annual averages.
What Medicare paid for the median South Dakota hospitalist’s services in 2024
Medicare paid about $44,804 for the median South Dakota hospitalist’s services in 2024, and the median hospitalist billed 696 services. Two separate medians, which need not come from the same doctor.
76 providers · South Dakota · 2024
The middle half ran from $28,568 to $60,578.
| Measure | 25th percentile | Median | 75th percentile | 90th percentile | vs. US median |
|---|---|---|---|---|---|
| Services per providerFrom CMS · services | 331 | 696 | 843 | 1,212 | +46% |
| Medicare patients per providerFrom CMS · patients | 152 | 247 | 307 | 461 | +26% |
| Allowed amount per providerFrom CMS · USD | $36,142 | $57,056 | $77,169 | $113,937 | +10% |
| Medicare payment per providerFrom CMS · USD | $28,568 | $44,804 | $60,578 | $89,908 | +10% |
| Standardized payment per providerFrom CMS · USDSame payment rates in every state, so local price differences drop out. | $29,491 | $46,933 | $63,355 | $93,727 | +17% |
| Services per patientCalculated by Aclera · services / patient | 1.78 | 2.64 | 3.21 | 4.06 | +2% |
| Standardized payment per patientCalculated by Aclera · USD / patientStandardized payment divided by the provider’s Medicare patients. | $132.59 | $196.58 | $232.14 | $301.13 | -4% |
| Submitted charges / allowed amountCalculated by Aclera · ratioHow far above Medicare’s allowed amount the charges were set. A billing-office number, not a clinical one. | 2.85 | 2.99 | 3.32 | 3.55 | +6% |
The dollars are Medicare’s payments for care billed under each hospitalist’s NPI. Your pay isn’t in them.
Original Medicare only. Medicare Advantage, commercial and Medicaid patients aren’t in these files, so the counts and totals are floors.
The visits behind it
The median South Dakota hospitalist billed Medicare 68 admissions, 459 follow-up visits and 87 discharges in 2024. Critical care, prolonged services and advance care planning: zero of each at the median. Those are the codes that pay for the 2 a.m. work.
| Per hospitalist | P25 | Median | P75 | P90 |
|---|---|---|---|---|
| Admissions and initial visits | 39 | 68 | 118 | 258 |
| Follow-up days | 167 | 459 | 634 | 792 |
| Discharges | 25 | 87 | 127 | 156 |
| Critical care | 0 | 0 | 0 | 0 |
| Prolonged visits | 0 | 0 | 0 | 0 |
| Advance care planning | 0 | 0 | 0 | 0 |
| Other services | 0 | 0 | 0 | 70 |
| Work RVUs per hospitalist | 836 | 1,211 | 1,639 | 2,467 |
Matched-code coverage for the work RVUs: a median 98% of these hospitalists’ Medicare services.
73 of 76 hospitalists have at least one code row, and only they’re in these rows. CMS withholds a hospitalist’s row for any code they billed for 10 or fewer patients, so that code reads as zero for them here.
Facility visits only. 1% of these hospitalists’ services were billed at non-facility places (clinic, nursing facility) and are counted under the work RVUs but not in the visit rows.
The codes behind each row
- Admissions and initial visits
- 99221, 99222, 99223, 99234, 99235, 99236
- Follow-up days
- 99231, 99232, 99233
- Discharges
- 99238, 99239
- Critical care
- 99291, 99292
- Prolonged visits
- G0316, 99418
- Advance care planning
- 99497, 99498
Counted under the NPI that billed them. A colleague’s, an NP’s or a PA’s visits are here only when billed under it.
Medicare’s price for an hour of your work
Medicare’s payment for the median South Dakota hospitalist’s services comes to about $96 an hour in 2024, on the minutes Medicare assumes each visit takes. You know what your group pays you an hour.
- P25
- $94/hour
- Median
- $96/hour
- P75
- $99/hour
Those minutes aren’t your shift hours: cross-cover, calls and unbilled time aren’t in them. The payment also covers practice expense and malpractice, on top of the work.
Matched codes cover a median 98% of these hospitalists’ Medicare services. The hourly leaves out 1 of the 73 because they had too little matched activity (under half their services).
- Hourly rate
- equals 60 x sum(services x average Medicare payment) / sum(services x CMS minutes), matched codes only
Whose patients these are
Median age 75. Median risk score 2.27, where 1.00 is the average Medicare patient. 21% also on Medicaid at the median.
- Median patient age
- 75
- Dual-eligible share
- 21%
- Median risk score
- 2.27
Most common chronic conditions
Median share of each hospitalist’s Medicare patients with the condition.
- High cholesterol
- 75% or more
- High blood pressure
- 75% or more
- Rheumatoid arthritis or osteoarthritis
- 57%
- Ischemic heart disease
- 56%
- Chronic kidney disease
- 50%
- Heart failure
- 46%
About the patients. None of the hospitalist figures above is adjusted for them.
Medicare Advantage in South Dakota
35% of South Dakota’s Medicare-eligible people were in a Medicare Advantage plan in September 2026 (73,086 of 208,048). None of their care is on this page.
Source: CMS Medicare Advantage State/County Penetration, September 2026, file State_County_Penetration_MA_2026_09.csv.
Who’s counted
CMS lists 76 hospitalists in South Dakota in 2024, by the address on their enrollment. The hospitalists enrolled as Internal Medicine aren’t here, and the address is where they bill from, not always where they work.
Take it with you
- State
- South Dakota
- Year
- 2024
- Hospitalists counted
- 76
- Median Medicare payment per provider
- $44,804
- Median follow-up days
- 459
- Median hourly
- $96/hour
- Medicare Advantage share
- 35% (September 2026)
The dollars are Medicare’s payments for care billed under each hospitalist’s NPI. Your pay isn’t in them.
Original Medicare only. Medicare Advantage, commercial and Medicaid patients aren’t in these files, so the counts and totals are floors.
Sources
- MUP_PHY_R26_P05_V10_D24_Prov.csv · released May 21, 2026 · downloaded Oct 6, 2026
- Medicare Physician & Other Practitioners, by Provider (2024) · CMS data API, Hospitalist rows · downloaded Oct 14, 2026
- Medicare Physician & Other Practitioners, by Provider and Service (2024) · CMS data API, Hospitalist rows · downloaded Oct 14, 2026
- Physician Fee Schedule relative value file · RVU24D, member file PPRRVU24_OCT.csv, last modified Sep 9, 2024 · downloaded Oct 14, 2026
- Physician work time file · CY 2024 PFS final rule physician work time (CMS-1784-F), 2023-12-18, member file CMS-1784-F_Work_Time_508_18DEC23.txt · downloaded Oct 14, 2026
- Medicare Advantage State/County Penetration · September 2026, member file State_County_Penetration_MA_2026_09.csv · downloaded Oct 14, 2026
aclera-ai.com/hospitalists/south-dakota/
Also from Aclera
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Common questions
Does the hospital really get $14,869 for a sepsis admission while the fees for the doctor’s visits come to $445?
For the hospital, yes: Medicare’s own average 2024 payment per stay to South Dakota hospitals, from the inpatient file. The visit figure is ours: one physician’s admission, daily visits and discharge at the codes South Dakota hospitalists bill most, priced at what Medicare paid per code on average in 2024 when a South Dakota hospitalist billed it. The hospital’s payment covers the whole stay, nurses to building. It’s one sum per admission, set mostly by the DRG and the hospital’s own rate. Which DRG the admission lands in depends on what the chart documents. The visits are paid as one fee each, to whoever bills them.
Is this what hospitalists in South Dakota earn?
No. It’s what Original Medicare paid for the care billed under each hospitalist’s NPI in 2024. Your salary is your employer’s number, and it isn’t in any of these files. The RVU bonus calculator works out what your own contract pays from your offer sheet.
Why only 76 hospitalists? South Dakota has more than that.
CMS counts only the providers it classifies as Hospitalist. Plenty of hospitalists are enrolled as Internal Medicine, and they aren’t here. The ones counted are placed by the address on their enrollment, which is where they bill from, not always where they work.
Where do the minutes in the hourly rate come from?
CMS’s physician time file for the 2024 fee schedule. It lists the minutes CMS assumes each code takes when it prices that code. Only codes in the file count toward the hourly, and in South Dakota they cover a median 98% of these hospitalists’ Medicare services.
Sources and method
- Medicare Physician & Other Practitioners, by Provider (2024)
CMS data API, Hospitalist rows · downloaded Oct 14, 2026
SHA-256: 54531644365d556d1423ef59a29273ef0f62db3eee8eec78fb96271db7aa14a6
- Medicare Physician & Other Practitioners, by Provider and Service (2024)
CMS data API, Hospitalist rows · downloaded Oct 14, 2026
SHA-256: beeb7b74496e9efd443d3622c06b31b7662371c14ca79fea2750d0da1c303d7e
- Physician Fee Schedule relative value file
RVU24D, member file PPRRVU24_OCT.csv, last modified Sep 9, 2024 · downloaded Oct 14, 2026
SHA-256: 6c807ee09ac424b707ac2eed130ae17b91c112e6bc1e971109d120534de17fff
- Physician work time file
CY 2024 PFS final rule physician work time (CMS-1784-F), 2023-12-18, member file CMS-1784-F_Work_Time_508_18DEC23.txt · downloaded Oct 14, 2026
SHA-256: 8b2965a5c293b2300bef862be5dbc2aa16cb6edbf893444bb3a0aa37958094de
- Medicare Advantage State/County Penetration
September 2026, member file State_County_Penetration_MA_2026_09.csv · downloaded Oct 14, 2026
SHA-256: b7d66e89cebcd0c68a11ea8a931c2fa896a0f158517c08833b28081f9332862c
- Medicare Inpatient Hospitals, by Provider and Service (2024)
CMS data API, every hospital’s DRG rows · downloaded Oct 14, 2026
SHA-256: 8ff15f645d1669fe4a58828c9b881cd0add70c0b5f2412614798b589824bd3c4
- IPPS FY 2025 final rule, Table 5
member file FY2025 IPPS Correction Notice Table 5.txt, last modified Sep 30, 2024 · downloaded Oct 14, 2026
SHA-256: d5e0a0bd231412e1828ee3d1629cc1da2c0731b93fad1585a1aaa3ade9f798ed
- Medicare Physician & Other Practitioners, by Provider (2018)
CMS data API, Hospitalist rows · downloaded Oct 14, 2026
SHA-256: 3d47bf3276b879e403668385d43f6676a2125697bf863d33df9b707e0b1d1f20
- Medicare Physician & Other Practitioners, by Provider (2019)
CMS data API, Hospitalist rows · downloaded Oct 14, 2026
SHA-256: 92c9e00b13120185ecd20574b38ad879f6a926bf659f0be1295ae1cbbe09e50c
- Medicare Physician & Other Practitioners, by Provider (2020)
CMS data API, Hospitalist rows · downloaded Oct 14, 2026
SHA-256: 97b9403ebebacbaf937de78c4c1b43ff7b90ed4146f7cdade648626a86eae6bc
- Medicare Physician & Other Practitioners, by Provider (2021)
CMS data API, Hospitalist rows · downloaded Oct 14, 2026
SHA-256: 4bb27c1b64315160fd32027437d20897fcc215902b187ccd98769378fd640673
- Medicare Physician & Other Practitioners, by Provider (2022)
CMS data API, Hospitalist rows · downloaded Oct 14, 2026
SHA-256: 9e41ea9c70668322177aa008bc894949407799d531d132abc0f430ccfb76b2e0
- Medicare Physician & Other Practitioners, by Provider (2023)
CMS data API, Hospitalist rows · downloaded Oct 14, 2026
SHA-256: 1d159e7bfa2bec1676e5aacc1363fa242d6d1553c1f02adb5b28c790c23507c5
- BLS CPI-U annual averages, 2018 to 2024
The 11 rule
A figure is published only when it comes from at least 11 hospitalists.
How the figures are calculated
Each provider counts once. Percentiles interpolate between neighboring ranks, and ratios are worked out per provider before the percentile is taken. A state needs at least 11 providers before we show a distribution, the same cutoff CMS uses to hide any figure drawn from 10 or fewer patients. In the 2024 file every provider reported every measure, so nothing was excluded.
Patients and services
A patient can appear under several providers, so adding the counts double-counts people. CMS counts services its own way and the unit varies with the kind of service, so services don’t convert into admissions, shifts, or wRVUs.
Matched codes
Only codes that appear in CMS’s time file (hourly) or relative value file (work RVUs) are counted. The share they cover is printed beside each figure.
The payment table counts everyone. The 3 hospitalists with no code row at all are missing from the visit rows and work RVUs, and the hourly leaves out 1 more with too little matched activity. The work RVUs are added up from each code’s own row, not from the services count.
What isn’t in these files
The payment files hold Original Medicare claims only. Medicare Advantage, commercial and Medicaid patients aren’t in them, and neither is salary. Nothing in them records shifts or nights.
Nearby states
Minnesota
249 hospitalists counted. Sepsis stay: 3 cents on the dollar.
Iowa
198 hospitalists counted. Sepsis stay: 3 cents on the dollar.
Nebraska
182 hospitalists counted. Sepsis stay: 3 cents on the dollar.
North Dakota
101 hospitalists counted. Sepsis stay: 3 cents on the dollar.
Montana
81 hospitalists counted. Sepsis stay: 3 cents on the dollar.
Wyoming
18 hospitalists counted. Sepsis stay: 2 cents on the dollar.
More
Hospitalists by state
One Medicare admission. One payment to the hospital, and much smaller fees for the hospitalist’s visits. State by state.
Medicare data
See what Medicare paid for hospitalist care in 2024.
RVU bonus
See what your RVU bonus would pay.
Work RVUs by code
See the work RVU for the E/M codes you bill on the wards.
Calculators