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

20205 Deep biopsy of muscle CPT · Musculoskeletal procedure

Classification Procedure › Musculoskeletal (CMS RBCS)

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

National scale 221 services ▲ 32.3% YoY · 171 beneficiaries (CY2024, Medicare FFS)

Medicare paid $38K · $171.94 avg / service, national

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

Billing groups

Named-group FFS services

108

FFS of Medicare

49%

Services YoY

+32.3%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~201 services

108 observed fee-for-service (54%) · ~93 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 — 20205 (CY2024)

TX 54 HI 41 CA 41 MD 23 MN 18

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

Named-group submitted charges

$88K

Named-group allowed amount

$12K

Named-group Medicare payments

$9K

Avg charge / svc

$817

Avg allowed / svc

$115

Avg payment / svc

$87

Average charge per group

$576–645

$645–713

$713–782

$782–850

$850–919

$919–987

$987–1,056

$1,056+

$576 6 groups · avg submitted charge / service $1,226

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 20205 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	20205 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	SUTTER COAST HOSPITAL	CRESCENT CITY	CA	INTERNAL MEDICINE	26	26	$19,526	$751	premium	63.4%	(707) 464-6715
2	JOHNS HOPKINS UNIVERSITY	BALTIMORE	MD	NURSE PRACTITIONER	2900	23	$18,875	$821	premium	100.0%	(410) 502-4340
3	PRACTICE ASSOCIATES MEDICAL GROUP	MORRISTOWN	NJ	NURSE PRACTITIONER	1404	16	$9,216	$576	premium	100.0%	(973) 971-5596
4	STANFORD HEALTH CARE	STANFORD	CA	DIAGNOSTIC RADIOLOGY	3039	15	$18,384	$1,226	premium	36.6%	(650) 723-4000
5	UNIVERSITY PHYSICIANS INCORPORATED	AURORA	CO	PHYSICIAN ASSISTANT	3122	14	$11,494	$821	premium	100.0%	(720) 777-1234
6	CLEVELAND CLINIC	CLEVELAND	OH	PHYSICIAN ASSISTANT	6828	14	$10,696	$764	premium	100.0%	—

*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 →