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

23410 Repair of acute torn shoulder rotator cuff 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 373 services ▼ 9.9% YoY · 361 beneficiaries (CY2024, Medicare FFS)

Medicare paid $312K · $836.53 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

174

Attributable volume · fee-for-service

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

-9.9%

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

~345 services

174 observed fee-for-service (50%) · ~171 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 — 23410 (CY2024)

TX 70 MS 61 CA 50 OK 43 TN 40

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

$535K

Named-group allowed amount

$97K

Named-group Medicare payments

$77K

Avg charge / svc

$3,076

Avg allowed / svc

$559

Avg payment / svc

$442

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

$957–1,507

$1,507–2,058

$2,058–2,608

$2,608–3,159

$3,159–3,709

$3,709–4,260

$4,260–4,810

$4,810+

$957 9 groups · avg submitted charge / service $6,280

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.

View the live example →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 23410 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	23410 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	TEXAS JOINT INSTITUTE, PLLC	DALLAS	TX	PHYSICIAN ASSISTANT	39	40	$107,374	$2,684	premium	57.1%	(972) 566-5255
2	THE COLUMBUS ORTHOPAEDIC CLINIC, P.A.	COLUMBUS	MS	NURSE PRACTITIONER	47	36	$103,402	$2,872	premium	59.0%	(662) 328-1012
3	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	CA	INTERNAL MEDICINE	3716	19	$75,639	$3,981	premium	38.0%	(415) 600-1020
4	STILLWATER MEDICAL CENTER AUTHORITY	STILLWATER	OK	PHYSICIAN ASSISTANT	166	14	$13,398	$957	premium	32.6%	(405) 372-1480
5	CEDAR VALLEY MEDICAL SPECIALISTS PC	WATERLOO	IA	NURSE PRACTITIONER	83	14	$50,540	$3,610	premium	42.4%	—
6	MINIVASIVE PAIN SPECIALISTS,PLLC	HOUSTON	TX	NURSE PRACTITIONER	27	13	$30,056	$2,312	premium	18.6%	(346) 800-6001
7	MAYO CLINIC	ROCHESTER	MN	NURSE PRACTITIONER	4896	13	$81,640	$6,280	premium	100.0%	(507) 284-2511
8	TENNESSEE ORTHOPAEDIC ALLIANCE PA	NASHVILLE	TN	PHYSICIAN ASSISTANT	352	13	$41,717	$3,209	premium	32.5%	(615) 329-6600
9	WEST TENNESSEE BONE AND JOINT CLINIC PC	JACKSON	TN	ORTHOPEDIC SURGERY	60	12	$31,500	$2,625	premium	30.0%	(731) 661-9825

*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 →