Medicare procedure market data by CPT code & state

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

0523T Measurement fractional flow reserve in arteries of heart with 3d functional mapping during procedure HCPCS · Cardiovascular procedure

Classification Procedure › Cardiovascular › Percutaneous Coronary Artery Angioplasty and Stenting (CMS RBCS)

First observed 2019

National scale 394 services ▲ 672.5% YoY · 392 beneficiaries (CY2024, Medicare FFS)

Medicare paid $70K · $177.63 avg / service, national

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

Billing groups

Named-group FFS services

304

FFS of Medicare

49%

Services YoY

+672.5%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~552 services

304 observed fee-for-service (55%) · ~248 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 — 0523T (CY2024)

KS 145 CA 53 FL 44 NE 42 VA 37

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

Named-group submitted charges

$141K

Named-group allowed amount

$75K

Named-group Medicare payments

$60K

Avg charge / svc

$462

Avg allowed / svc

$248

Avg payment / svc

$198

Average charge per group

$150–213

$213–276

$276–339

$339–401

$401–464

$464–527

$527–590

$590+

$150 11 groups · avg submitted charge / service $705

Market analyticsPlatform

a taste of the twelve-year trend layer

Market position — where this market sits on volume and growth among all state markets, and its rank.
Worth a look — every state market for this search, ranked by a published score: size, growth, fragmentation, below-expected volume.
Lookalike opportunities — groups billing below what peers of the same specialty, size, and state predict, with the expected figure shown.
National benchmarks — where each group's volume sits nationally and within its specialty.
Market structure — how concentrated this market is, and who owns the volume.
Medicare-wide scaling — the payer split, and this market total scaled to all of Medicare, labeled as an estimate.

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

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Nevvi's market analytics platform — code baskets, market structure and share, the twelve-year trend layer — is built and not launched yet. We're gathering interest in it.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 0523T services, highest first, CY2024
#	Physician group activate to sort	City activate to sort	St activate to sort	Specialty activate to sort	Providers activate to sort	0523T svcs sorted descending — activate to reverse	Submitted charges activate to sort	Avg charge activate to sort	Medicare $ locked column	Share* activate to sort	Phone
1	SCRIPPS HEALTH	LA JOLLA	CA	PHYSICIAN ASSISTANT	1431	53	$37,365	$705	premium	100.0%	(858) 455-9100
2	KANSAS HEART HOSPITAL, LLC	WICHITA	KS	NURSE PRACTITIONER	24	52	$31,200	$600	premium	35.9%	(316) 630-5000
3	VALLEY PHYSICIAN SERVICES PC	HOBOKEN	VA	NURSE PRACTITIONER	606	37	$14,800	$400	premium	100.0%	(800) 825-5391
4	HEALTHTEXAS PROVIDER NETWORK	DALLAS	TX	PHYSICIAN ASSISTANT	2482	34	$8,639	$254	premium	100.0%	—
5	THE HEART CENTER OF PALM COAST, LLC	PALM COAST	FL	CARDIOVASCULAR DISEASE (CARDIOLOGY)	2	32	$4,804	$150	premium	72.7%	8322643744000
6	UNMC PHYSICIANS	OMAHA	NE	PHYSICIAN ASSISTANT	1514	19	$11,020	$580	premium	45.2%	(402) 559-4000
7	ASCENSION MEDICAL GROUP VIA CHRISTI PA	WICHITA	KS	FAMILY PRACTICE	186	15	$8,250	$550	premium	10.3%	(316) 689-9349
8	JOHNSTOWN HEART AND VASCULAR CENTER, INC	JOHNSTOWN	PA	CARDIOVASCULAR DISEASE (CARDIOLOGY)	6	14	$3,880	$277	premium	100.0%	(814) 619-4587
9	VALLEY PHYSICIAN SERVICES PC	HOBOKEN	NJ	NURSE PRACTITIONER	606	14	$5,600	$400	premium	100.0%	(800) 825-5391
10	CHI HEALTH CLINIC SPECIALTY LLC	LINCOLN	NE	NURSE PRACTITIONER	309	12	$6,960	$580	premium	28.6%	(402) 219-8000
11	INTEGRATED CARDIOLOGY GROUP LLC	LINCOLN	NE	PHYSICIAN ASSISTANT	78	11	$3,707	$337	premium	26.2%	(402) 483-3333
12	CARDIOJOST PLLC	MESA	AZ	CARDIOVASCULAR DISEASE (CARDIOLOGY)	17	11	$4,362	$397	premium	100.0%	(480) 422-8533

*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 →