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Increasing health care costs are a significant concern in the United States medical system. Though radiation oncology was targeted for cost reductions based on expenditure growth from 2002 through 2009 (Alhassani NEJM 2012), subsequent analysis suggested stabilization of radiation oncology charges by 2012 (Maroongroge IJROBP 2014). In 2019, the Centers for Medicare and Medicaid Services (CMS) proposed a new radiation oncology model aimed at further reducing Medicare expenditures while improving the quality of beneficiary care. We examined changes in aggregate Medicare charges allowed per specialty to provide contemporary context to proposed changes and hypothesize that radiation oncology charges remained stable through 2017. Materials/Methods: Medicare physicians/suppliers utilization, program payments and balance billing for original Medicare beneficiaries, by physician specialty, was analyzed from 2002 to 2017. Total allowed charges under the Medicare physician/supplier fee-for-service program, inflation adjusted charges, and percent of total charges billed per specialty were examined. We adjusted for inflation using the consumer price index for medical care from the US Bureau of Labor Statistics. Results: Total allowed charges for all specialties went from $83 billion in 2002 to $138 billion in 2017. The top three specialties accounting for the most charges billed to Medicare were internal medicine, ophthalmology, and hematology/oncology. Radiation oncology charges accounted for 1.

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