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

23440 Removal or relocation of biceps tendon 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 985 services ▼ 3.1% YoY · 982 beneficiaries (CY2024, Medicare FFS)

Medicare paid $617K · $626.47 avg / service, national

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

Billing groups

Named-group FFS services

443

FFS of Medicare

49%

Services YoY

-3.1%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~890 services

443 observed fee-for-service (50%) · ~447 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 — 23440 (CY2024)

VA 197 FL 137 AR 128 TX 97 MN 89

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

Named-group submitted charges

$914K

Named-group allowed amount

$92K

Named-group Medicare payments

$74K

Avg charge / svc

$2,062

Avg allowed / svc

$208

Avg payment / svc

$166

Average charge per group

$993–1,346

$1,346–1,699

$1,699–2,052

$2,052–2,405

$2,405–2,758

$2,758–3,111

$3,111–3,464

$3,464+

$993 12 groups · avg submitted charge / service $4,190

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 23440 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	23440 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	UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES	LITTLE ROCK	AR	NURSE PRACTITIONER	1241	71	$147,112	$2,072	premium	55.5%	(501) 686-8000
2	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	CA	INTERNAL MEDICINE	3716	57	$62,474	$1,096	premium	100.0%	(415) 600-1020
3	BURLINGTON COUNTY ORTHOPAEDIC SPECIALISTS PA	MOUNT LAUREL	NJ	ORTHOPEDIC SURGERY	5	51	$97,500	$1,912	premium	100.0%	(856) 235-7080
4	ORTHOARKANSAS PA	LITTLE ROCK	AR	PHYSICAL THERAPIST IN PRIVATE PRACTICE	145	44	$73,150	$1,663	premium	34.4%	(501) 500-3500
5	COLLIER SPORTS MEDICINE AND ORTHOPAEDIC CENTER PA	NAPLES	FL	PHYSICIAN ASSISTANT	4	42	$51,485	$1,226	premium	30.7%	2395933500206
6	HEINRICH-JOSEY ORTHOPAEDICS	AUSTIN	TX	PHYSICIAN ASSISTANT	22	41	$171,810	$4,190	premium	42.3%	(512) 476-2830
7	SUMMIT ORTHOPEDICS, LTD	SAINT PAUL	MN	PHYSICIAN ASSISTANT	271	26	$74,326	$2,859	premium	29.2%	(651) 968-5201
8	STRAUB CLINIC AND HOSPITAL	HONOLULU	HI	NURSE PRACTITIONER	431	24	$23,829	$993	premium	100.0%	(808) 522-4000
9	BURLINGTON COUNTY ORTHOPAEDIC SPECIALISTS PA	MOUNT LAUREL	CT	ORTHOPEDIC SURGERY	5	19	$11,875	$625	premium	100.0%	(856) 235-7080
10	BANNER CHURCHILL COMMUNITY HOSPITAL	FALLON	IL	PHYSICIAN ASSISTANT	22	18	$54,000	$3,000	premium	100.0%	(775) 423-3151
11	WESTERN PENNSYLVANIA HAND CENTER	WEXFORD	PA	OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE	18	18	$46,756	$2,598	premium	23.7%	(724) 933-3850
12	ALLINA HEALTH SYSTEM	MINNEAPOLIS	MN	PHYSICIAN ASSISTANT	3855	18	$63,221	$3,512	premium	20.2%	(612) 863-4000
13	THE ANDERSON CLINIC INC	ALEXANDRIA	VA	ORTHOPEDIC SURGERY	79	14	$36,096	$2,578	premium	7.1%	(703) 892-6500

*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 →