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Market snapshot

12004 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

12004 — Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 7.6-12.5 cm

Billing groups
2
Named-group FFS services
53
FFS of Medicare
49%
Services YoY
+339.1%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~108 services

53 observed fee-for-service (49%) · ~55 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 — 12004 (CY2024)

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

Named-group submitted charges
$14K
Named-group allowed amount
$3K
Named-group Medicare payments
$3K
Avg charge / svc
$264
Avg allowed / svc
$65
Avg payment / svc
$51
Average charge per group
$162 2 groups · avg submitted charge / service $524
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a taste of the twelve-year trend layer

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 12004 services, CY2024
#Physician group City St Specialty Providers 12004 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 LACKAWANNA VALLEY DERMATOLOGY ASSOCIATES LIMITED SCRANTON PA PHYSICIAN ASSISTANT 18 38 $6,156 $162 premium 100.0% (570) 961-5522
2 GEORGETOWN PHYSICIAN ASSOCIATES, LLC MURRELLS INLET SC FAMILY PRACTICE 230 15 $7,860 $524 premium 100.0% (843) 652-8450

*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 →