NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
23395 Relocation of one muscle of shoulder or upper arm CPT · Musculoskeletal procedure
Classification Procedure › Musculoskeletal › Shoulder Repair or Replacement - Open (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 2,300 services ▲ 18.1% YoY · 2,264 beneficiaries (CY2024, Medicare FFS)
Medicare paid $950K · $413.05 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
25
Named-group FFS services
1,060
FFS of Medicare
49%
Services YoY
+18.1%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~2,242 services

1,060 observed fee-for-service (47%) · ~1,182 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 — 23395 (CY2024)
FL 389 TX 285 OR 245 DE 204 CT 187

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

Named-group submitted charges
$3.5M
Named-group allowed amount
$380K
Named-group Medicare payments
$303K
Avg charge / svc
$3,329
Avg allowed / svc
$358
Avg payment / svc
$286
Average charge per group
$974 25 groups · avg submitted charge / service $6,401
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 23395 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 SOUTHERN OREGON ORTHOPEDICS INC MEDFORD OR PHYSICIAN ASSISTANT 61 202 $724,742 $3,588 82.4% (541) 779-6250
2 HEINRICH-JOSEY ORTHOPAEDICS AUSTIN TX PHYSICIAN ASSISTANT 22 100 $640,100 $6,401 35.1% (512) 476-2830
3 COLLIER SPORTS MEDICINE AND ORTHOPAEDIC CENTER PA NAPLES FL PHYSICIAN ASSISTANT 4 88 $173,712 $1,974 22.6% 2395933500206
4 UNITED HOSPITAL CENTER INC BRIDGEPORT WV PHYSICIAN ASSISTANT 298 72 $182,853 $2,540 100.0% (681) 342-1842
5 TEXAS ORTHOPEDIC SPECIALISTS, PLLC BEDFORD TX ORTHOPEDIC SURGERY 14 70 $88,088 $1,258 24.6% (817) 540-4477
6 TOCA AT BANNER HEALTH LLC SCOTTSDALE AZ PHYSICIAN ASSISTANT 26 66 $140,548 $2,130 67.3% (602) 277-6211
7 ORTHOPAEDIC AND NEUROSURGERY SPECIALISTS, PLLC GREENWICH CT PHYSICIAN ASSISTANT 259 56 $357,896 $6,391 29.9% (203) 869-1145
8 MICHAEL R DIBENEDETTO MD PLLC PONDERAY MI ORTHOPEDIC SURGERY 9 37 $52,144 $1,409 100.0% (208) 265-9817
9 MASSACHUSETTS GENERAL PHYSICIANS ORGANIZATION INC BOSTON MA DIAGNOSTIC RADIOLOGY 3532 34 $188,138 $5,533 100.0% (617) 724-0287
10 ORTHOPAEDIC AND NEUROSURGERY SPECIALISTS, PLLC GREENWICH NY PHYSICIAN ASSISTANT 259 33 $210,903 $6,391 35.5% (203) 869-1145
11 BANNER - UNIVERSITY PHYSICIAN SPECIALISTS LLC PHOENIX AZ PHYSICIAN ASSISTANT 349 32 $66,928 $2,092 32.7% (602) 839-3927
12 CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC AKRON OH PHYSICIAN ASSISTANT 41 27 $31,925 $1,182 100.0% (330) 668-4085
13 KENNEDY WHITE AND RIGGS ORTHOPEDIC ASSOCIATES SARASOTA FL PHYSICIAN ASSISTANT 40 27 $42,080 $1,558 6.9% (941) 365-0655
14 KEVIN J PELTON MD INC LOS ANGELES CA PHYSICIAN ASSISTANT 38 25 $57,688 $2,308 33.8% (323) 264-7600
15 ORTHOPAEDIC CLINIC OF SALINA SALINA OR ORTHOPEDIC SURGERY 17 22 $52,822 $2,401 9.0% —
16 LUMINIS HEALTH MEDICAL GROUP, LLC ANNAPOLIS MD PHYSICIAN ASSISTANT 544 22 $31,878 $1,449 20.4% (443) 481-1000
17 WESTERN PENNSYLVANIA HAND CENTER WEXFORD PA OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE 18 17 $62,000 $3,647 9.3% (724) 933-3850
18 AMBER HILL PHYSICAL THERAPY INC FREDERICK DC ORTHOPEDIC SURGERY 327 16 $55,230 $3,452 27.6% —
19 REGENTS OF THE UNIVERSITY OF CALIFORNIA SANTA MONICA CA ORTHOPEDIC SURGERY 67 15 $91,189 $6,079 20.3% (310) 319-1234
20 BON SECOURS MEDICAL GROUP GREENVILLE SPECIALTY CARE LLC GREENVILLE SC NURSE PRACTITIONER 288 15 $41,685 $2,779 100.0% (864) 255-1901
21 WHITE PLAINS PHYSICIAN SERVICES PC WHITE PLAINS NY PHYSICIAN ASSISTANT 383 14 $79,017 $5,644 15.1% (914) 681-0600
22 WHITE PLAINS PHYSICIAN SERVICES PC WHITE PLAINS NJ PHYSICIAN ASSISTANT 383 13 $14,675 $1,129 100.0% (914) 681-0600
23 FIRST STATE ORTHOPAEDICS PA NEWARK PA PHYSICIAN ASSISTANT 98 12 $11,688 $974 6.6% (302) 731-2888
24 LSU HEALTH SCIENCES CENTER SHREVEPORT FACULTY GROUP PRACTICE SHREVEPORT LA PHYSICIAN ASSISTANT 589 12 $42,816 $3,568 100.0% (318) 675-8700
25 JOHNS HOPKINS UNIVERSITY BALTIMORE MD NURSE PRACTITIONER 2900 11 $27,840 $2,531 10.2% (410) 502-4340
26 TRIA ORTHOPAEDIC CENTER LLC BLOOMINGTON MN PHYSICAL THERAPIST IN PRIVATE PRACTICE 508 11 $11,269 $1,024 14.9% (952) 831-8742
27 ENDEAVOR HEALTH MEDICAL GROUP EVANSTON IL NURSE PRACTITIONER 3380 11 $48,741 $4,431 26.2% —

*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 →