Medicare procedure market data by CPT code & state

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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

00873 Anesthesia for shock wave therapy for urinary system stones without water bath CPT · Anesthesia

Classification Anesthesia › Anesthesia (CMS RBCS)

First observed 2013 — start of our 12-year window; the code predates it

National scale 8,064 services ▼ 8.9% YoY · 7,580 beneficiaries (CY2024, Medicare FFS)

Medicare paid $821K · $101.83 avg / service, national

CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window

Billing groups

124

Named groups billing this code

Named-group all-Medicare svcs · est.

10,263

Scaled from 5,322 observed FFS services.

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

-4.7%

All-Medicare est. · observed FFS -8.9%

Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.

Estimated all-Medicare volume estimate

FFS + estimated MA

~10,263 services

5,322 observed fee-for-service (52%) · ~4,941 estimated Medicare Advantage.

Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale

Top states — 00873 (CY2024)

NJ 876 MS 657 SC 613 TX 474 FL 471

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Billed → allowed → paid

Named-group submitted charges

$6.7M

Named-group allowed amount

$669K

Named-group Medicare payments

$527K

Avg charge / svc

$1,265

Avg allowed / svc

$126

Avg payment / svc

$99

Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.

Average charge per group

$194–563

$563–933

$933–1,303

$1,303–1,673

$1,673–2,042

$2,042–2,412

$2,412–2,782

$2,782+

$194 124 groups · avg submitted charge / service $6,180

Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — the free tier previews every panel, gated.

Or just look at it: nuclear heart imaging (78452) in Arizona is open as a live example — the full paid view, real data.

View the live example →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 00873 services, highest first, CY2024
#	Physician group locked column	City locked column	St locked column	Specialty locked column	Providers locked column	00873 svcs	Submitted charges locked column	Avg charge locked column	Medicare $ locked column	Share of state* locked column	Phone
1	UNIVERSITY PHYSICIAN ASSOCIATES OF NEW JERSEY INC	NEWARK	NJ	INTERNAL MEDICINE	381	243	$285,180	$1,174	premium	27.7%	(973) 972-5004
2	MCLEOD PHYSICIAN ASSOCIATES II	FLORENCE	SC	PHYSICIAN ASSISTANT	534	232	$296,989	$1,280	premium	37.8%	—
3	VIRGINIA UROLOGY CENTER	RICHMOND	VA	UROLOGY	90	156	$104,846	$672	premium	50.3%	(804) 330-9105
4	RWJBH OBSERVATION ASSOCIATES LLC	SOMERVILLE	NJ	PHYSICIAN ASSISTANT	937	149	$176,805	$1,187	premium	17.0%	(908) 685-2200
5	NORTH AMERICAN PARTNERS IN ANESTHESIA OF NEW JERSEY LLC	PATERSON	NJ	ANESTHESIOLOGY	127	142	$466,391	$3,284	premium	16.2%	(973) 754-2000

That's the top 5 of 124 groups. The platform ranks the whole market — code baskets, benchmarks, and the full ranked list. the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. See Methods.

Comparing against an all-payer estimate?

These are exact counts from Medicare fee-for-service claims — roughly a third to half of most procedure markets, depending on payer mix. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →