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

20704 Insertion of drug-delivery device in joint CPT · Musculoskeletal procedure

Classification Procedure › Musculoskeletal › Joint Injection (CMS RBCS)

First observed 2020

National scale 280 services ▲ 95.8% YoY · 222 beneficiaries (CY2024, Medicare FFS)

Medicare paid $33K · $117.21 avg / service, national

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

Billing groups

Named groups billing this code

Named-group FFS services

Attributable volume · fee-for-service

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

+95.8%

FFS enrollment -2.2%

Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.

Estimated all-Medicare volume estimate

FFS + estimated MA

~146 services

67 observed fee-for-service (46%) · ~79 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 — 20704 (CY2024)

TX 184 MD 41 OH 20 FL 18 CA 17

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

Billed → allowed → paid

Named-group submitted charges

$34K

Named-group allowed amount

$10K

Named-group Medicare payments

$8K

Avg charge / svc

$514

Avg allowed / svc

$151

Avg payment / svc

$121

Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.

Average charge per group

$299–349

$349–399

$399–449

$449–499

$499–550

$550–600

$600–650

$650+

$299 4 groups · avg submitted charge / service $724

Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — the free tier previews every panel, gated.

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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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 20704 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	20704 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	PROMEDICA CENTRAL PHYSICIANS	TOLEDO	OH	PHYSICIAN ASSISTANT	794	20	$5,980	$299	premium	100.0%	(419) 291-2003
2	HOLY CROSS HOSPITAL INC	FT LAUDERDALE	FL	PHYSICIAN ASSISTANT	303	18	$10,132	$563	premium	100.0%	(954) 772-2136
3	REGENTS OF THE UNIVERSITY OF CALIFORNIA	SANTA MONICA	CA	ORTHOPEDIC SURGERY	67	17	$12,308	$724	premium	100.0%	(310) 319-1234
4	TEXAS JOINT INSTITUTE, PLLC	DALLAS	TX	PHYSICIAN ASSISTANT	39	12	$6,001	$500	premium	6.5%	(972) 566-5255

*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 →