I was shocked a few years ago when I discovered this. It only required a few hours to be educated how extremely adroit these institutions become once they start paying Wall Street level executive salaries to attract talent.
From AMA 2018 990 Tax Filing ‘Non Profit’ report: Return of Organization Exempt From Income Tax
(5) Royalties… $158,584,546 (2018) -up from $70M in 2011
Yes, they receive royalties from the copyrighting CPT codes. They get a LOT of royalties. Because it is mandated by the Government (CMS), my understanding of law was when it is mandated and declared a standard it is transitioned into the public domain as a public good. Like Miles per Hour for road speeds. Like letters and words. Like the Periodic Table.
Pretty smart leadership to pay 10% of their income stream to lobby the government and have the US Gov’t protect and enforce a privatized Monopoly.
2018 AMA is #9 in lobby spending. 2020 they are #6
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a) Current year … (2a) $19,752,406 (2018 - could not find 527(f) form)
This is an excellent legal study on Copyrighting Standards "When private organizations develop such standards, copyright protection of those standards often creates a conflict between private intellectual property rights and society’s need for standards. This conflict is especially apparent when a local or state government adopts a privately drafted standard as law. "