RegistryReach
The headline number is calm. Manufacturers reported $2.89 billion in general payments to U.S. providers in 2025, up 5.5% from $2.74 billion in 2024, spread across 1,020,608 paid providers (up from 984,069). Steady growth, a few percent more names on the list.
Roll the same two years up by physician specialty and the calm disappears. The 2025 growth was not evenly spread: a handful of specialties absorbed steep increases while some of the biggest traditional destinations for industry money actually shrank.
The movers
| Specialty family | 2025 | 2024 | Change |
|---|---|---|---|
| Urology | $60.5M | $36.5M | +66% |
| General Practice | $55.7M | $33.8M | +65% |
| Radiology | $74.4M | $54.9M | +36% |
| Internal Medicine (incl. subspecialties) | $754.7M | $606.6M | +24% |
| Plastic Surgery | $35.3M | $30.3M | +16% |
| Psychiatry & Neurology | $206.8M | $178.1M | +16% |
| Neurological Surgery | $93.4M | $84.0M | +11% |
| Dermatology | $116.2M | $107.7M | +8% |
| Surgery | $109.4M | $106.8M | +2% |
| Family Medicine | $53.5M | $55.5M | −4% |
| Ophthalmology | $65.5M | $69.8M | −6% |
| Orthopaedic Surgery (incl. subspecialties) | $588.0M | $628.8M | −6% |
| Obstetrics & Gynecology | $37.2M | $41.1M | −10% |
| Pediatrics | $45.3M | $54.2M | −16% |
The money followed the prescription pad
Read the winners and losers as two columns and a pattern falls out: pharma-facing specialties grew, procedure-facing specialties mostly didn't. The Internal Medicine family added $148M all by itself, more than the total payments to dermatology. Inside it, cardiology grew 13% to $85.5M and endocrinology, the specialty that writes the GLP-1 scripts, grew 22% to $46.5M. Psychiatry & Neurology added $29M. Meanwhile the operating room cooled: the orthopaedic family gave back $41M, and ophthalmology slipped 6%.
That's consistent with what the manufacturer league table showed from the paying side: AbbVie clear at #1 and Novo Nordisk climbing into the top ten on GLP-1 momentum, even while seven of the top ten payers were still device companies. The device money is still enormous; the specialty side just suggests it cooled first.
The two surprises
Urology's 66% jump is the sharpest move on the board, and it didn't come from more doctors: the paid-urologist headcount barely moved (9,784 to 9,965). The same names simply received a lot more money, roughly $6,100 per paid urologist in 2025 versus $3,700 the year before.
General Practice is the opposite shape: a big, quiet cohort of 27,443 paid providers whose per-head payments are small, but whose total grew 65% in a single year. When manufacturers start spending real money on generalists, that's usually a launch strategy you'll see named in next year's data.
Look it up yourself
Every figure here is computed from the federal Open Payments releases for program years 2024 and 2025, joined against the national provider registry. The interactive money map breaks the same data down by state and specialty, and each specialty page shows which manufacturers pay it.