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

19371 Removal of capsule around breast implant CPT · Breast procedure

Classification Procedure › Breast › Mastectomy (CMS RBCS)

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

National scale 392 services ▼ 20.0% YoY · 345 beneficiaries (CY2024, Medicare FFS)

Medicare paid $235K · $599.80 avg / service, national

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

Billing groups

Named-group FFS services

190

FFS of Medicare

49%

Services YoY

-20.0%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~395 services

190 observed fee-for-service (48%) · ~205 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 — 19371 (CY2024)

CA 144 AZ 79 LA 41 FL 35 TX 19

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

Named-group submitted charges

$1.3M

Named-group allowed amount

$131K

Named-group Medicare payments

$103K

Avg charge / svc

$6,950

Avg allowed / svc

$687

Avg payment / svc

$545

Average charge per group

$1,025–2,862

$2,862–4,698

$4,698–6,535

$6,535–8,371

$8,371–10,208

$10,208–12,044

$12,044–13,881

$13,881+

$1,025 11 groups · avg submitted charge / service $17,540

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 19371 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	19371 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	THE REGENTS OF THE UNIVERSITY OF CALIFORNIA	LOS ANGELES	CA	PLASTIC AND RECONSTRUCTIVE SURGERY	19	40	$275,625	$6,891	premium	27.8%	—
2	BUNDRICK AND O'NEAL PLASTIC SURGERY (AMC)	SHREVEPORT	LA	PLASTIC AND RECONSTRUCTIVE SURGERY	3	19	$61,200	$3,221	premium	46.3%	(318) 221-9671
3	JASON K POTTER MD DDS PA	DALLAS	TX	PHYSICIAN ASSISTANT	2	19	$264,000	$13,895	premium	100.0%	(214) 540-1420
4	THE GEORGIA INSTITUTE FOR PLASTIC SURGERY INC	SAVANNAH	GA	PLASTIC AND RECONSTRUCTIVE SURGERY	8	17	$143,000	$8,412	premium	100.0%	(912) 355-8000
5	NEW YORK UNIVERSITY	NEW YORK	NY	DIAGNOSTIC RADIOLOGY	5704	16	$280,640	$17,540	premium	100.0%	(212) 263-9700
6	SCRIPPS HEALTH	LA JOLLA	CA	PHYSICIAN ASSISTANT	1431	15	$61,868	$4,125	premium	10.4%	(858) 455-9100
7	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	CA	INTERNAL MEDICINE	3716	14	$78,039	$5,574	premium	9.7%	(415) 600-1020
8	SWEDISH HEALTH SERVICES	SEATTLE	WA	PHYSICIAN ASSISTANT	1033	14	$45,416	$3,244	premium	100.0%	—
9	PLASTIC SURGEONS OF NORTHERN ARIZONA P L L C	FLAGSTAFF	AZ	PLASTIC AND RECONSTRUCTIVE SURGERY	6	12	$35,188	$2,932	premium	15.2%	(928) 774-2300
10	DIGNITY HEALTH MEDICAL FOUNDATION	FOLSOM	CA	DIAGNOSTIC RADIOLOGY	1197	12	$63,147	$5,262	premium	8.3%	(916) 983-7476
11	CENTER FOR DERMATOLOGY PLLC	SCOTTSDALE	AZ	PHYSICIAN ASSISTANT	67	12	$12,300	$1,025	premium	15.2%	(480) 905-8485

*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 →