55% of AMA Revenue Comes From Codes You’re Forced to Use
How the AMA built a government-mandated monopoly that taxes every physician in America, whether they joined or not.
You wanted empirical evidence? Here it is. Substack just ranked me #1. Now let’s talk about why this category even exists… and who is grifting from it.
Every time you bill a patient, you pay the American Medical Association. Every time a hospital submits a claim, they pay the American Medical Association. Every time an insurance company processes a procedure, they pay the American Medical Association.
$300+ million per year.
You didn’t vote for this. You didn’t agree to it.
The United States government mandated it.
This is the story of how a “physician advocacy organization” built a toll booth on the practice of medicine.
IN TODAY’S ARTICLE:
How the AMA turned five-digit codes into $300+ million in annual revenue
Why no alternatives to CPT codes exist (and who made sure of that)
The 55% of AMA revenue that has nothing to do with membership
Every physician and patient pays the AMA, whether they joined or not
Glossary at the bottom of today’s article.
THE TOLL BOOTH
You know, Current Procedural Terminology (CPT) codes. The five-digit codes you attach to every procedure, every visit, every service you perform.
99203
99204
9920527447
72148
80053
You learned them in residency. You use them every day. You probably assume they’re part of the medical infrastructure. Like ICD codes. Like the periodic table.
They’re not.
The American Medical Association owns them.
Not the government. Not CMS. Not a public trust.
A private organization that represents 15% of American physicians owns the codes that 100% of American physicians must use.
And they charge for access.
THE NUMBERS
In 2024, the AMA reported total revenue of $546.2 million.
$301.4 million came from royalties.
That’s 55.2% of everything the AMA collects.
Not from membership dues. Not from advocacy. Not from education, but from licensing fees on codes that the government forces everyone to use.
The breakdown:
Every electronic health record system pays to include CPT codes.
Every billing software pays to include CPT codes.
Every medical coding textbook pays to include CPT codes.
Every hospital, every practice, every insurance company that wants to process a claim pays to access CPT codes.
CMS pays for the right to use CPT codes in Medicare billing.
The government mandates the codes. The AMA collects the rent.
HOW THIS HAPPENED
The AMA created CPT codes in 1966.
The original purpose was standardization. Before CPT, billing was chaos. Different procedures had different names in different regions. Claims processing was a mess.
CPT solved a real problem.
Then, in 1983, CMS adopted CPT as the mandatory coding system for Medicare. Then HIPAA made CPT the mandatory standard for all electronic healthcare transactions. The AMA didn’t lobby for universal healthcare. Instead, they lobbied for universal adoption of their proprietary coding system.
They got it.
Now every physician in America, whether they’re an AMA member or not, generates revenue for the AMA every time they see a patient.
If you’ve made it this far, you already understand the real advantage in healthcare isn’t ideology. It’s incentives.
Everyone receives the headlines.
Members get the playbook: the hidden pricing levers, the quiet subsidies, the cartel mechanics, and the obvious fixes nobody in power wants to say out loud.
If you want the part that changes how you see the system, become a Member.
