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

12013 Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm CPT · Skin procedure

Classification Procedure › Skin › Wound Repair - All Levels (CMS RBCS)

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

National scale 1,042 services ▲ 1.3% YoY · 880 beneficiaries (CY2024, Medicare FFS)

Medicare paid $45K · $43.30 avg / service, national

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

Billing groups

Named-group FFS services

247

FFS of Medicare

49%

Services YoY

+1.3%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~466 services

247 observed fee-for-service (53%) · ~219 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 — 12013 (CY2024)

CA 486 FL 129 TX 95 MA 48 WA 45

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

Named-group submitted charges

$90K

Named-group allowed amount

$13K

Named-group Medicare payments

$10K

Avg charge / svc

$363

Avg allowed / svc

$54

Avg payment / svc

$42

Average charge per group

$131–198

$198–265

$265–332

$332–400

$400–467

$467–534

$534–601

$601+

$131 14 groups · avg submitted charge / service $683

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.

View the live example →

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 12013 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	12013 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	SOUTHEASTERN DERMATOLOGY GROUP PA	PANAMA CITY	MS	PHYSICIAN ASSISTANT	43	28	$6,440	$230	premium	100.0%	—
2	LA JOLLA OBSERVATION MEDICINE	LA JOLLA	CA	EMERGENCY MEDICINE	25	28	$11,452	$409	premium	5.8%	(858) 626-6150
3	CNOS PC	SIOUX CITY	SD	PHYSICIAN ASSISTANT	99	26	$10,270	$395	premium	100.0%	(712) 279-3500
4	ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH IS	NEW BEDFORD	MA	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)	564	25	$8,325	$333	premium	52.1%	(781) 983-9088
5	PALM BEACH DERMATOLOGY	LAKE WORTH	FL	DERMATOLOGY	19	23	$3,795	$165	premium	17.8%	(561) 969-7300
6	MEMPHIS DERMATOLOGY CLINIC PA	MEMPHIS	TN	DERMATOLOGY	11	16	$2,320	$145	premium	100.0%	(901) 726-6655
7	EMERGENCY PHYSICIANS OF ST PETERSBURG PA	ST PETERSBURG	FL	EMERGENCY MEDICINE	15	15	$10,248	$683	premium	11.6%	(727) 553-7300
8	MAYO CLINIC ARIZONA	PHOENIX	AZ	PHYSICIAN ASSISTANT	1635	14	$3,952	$282	premium	50.0%	(800) 603-0558
9	MEDICAL SERVICES OF PRESCOTT, INC	PRESCOTT	AZ	EMERGENCY MEDICINE	9	14	$8,904	$636	premium	50.0%	(928) 445-2700
10	CAGR MEDICAL PLLC	OKLAHOMA CITY	OK	PHYSICIAN ASSISTANT	5	13	$1,703	$131	premium	100.0%	(405) 636-1506
11	PARAGON CONTRACTING SERVICES LLC	BIRMINGHAM	FL	EMERGENCY MEDICINE	367	12	$7,920	$660	premium	9.3%	(205) 838-3450
12	VITALSKIN MEDICAL GROUP IL PLLC	CHICAGO	IL	DERMATOLOGY	58	11	$2,746	$250	premium	32.4%	(773) 276-1100
13	SHERIDAN EMERGENCY PHYSICIAN SERVICES INC	JUPITER	IL	EMERGENCY MEDICINE	20	11	$7,260	$660	premium	32.4%	(954) 939-5000
14	LAHEY CLINIC INC	BURLINGTON	MA	NURSE PRACTITIONER	1400	11	$4,208	$383	premium	22.9%	—

*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 →