NEVVI Medicare utilization intelligence
+ Build a code basket
Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
23470 Partial replacement of shoulder joint 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 187 services · est. ▲ 14.6% YoY · 86 FFS beneficiaries (CY2024, all-Medicare estimate) — 87 observed fee-for-service services
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Market overview

Nationally, 3 billing groups and 6 clinicians bill 23470 — ~187 all-Medicare services · est. (87 observed FFS), and volume is up 14.7% year over year.

Market Brief 23470
The whole of 23470, written up and sourced.

The Brief is a national document for 23470. Its findings page carries one finding per chapter, each opening the chapter that prints its figure and the table behind it — like these, from the United States, CY2024, the market on this page.

  1. 1Size and growth. The national market for 23470 ran ~187 all-Medicare services (estimated), 87 observed fee-for-service in CY2024. The market is up 14.7% year over year. 3 billing groups and 6 clinicians bill it.
  2. 2Payment. Half the field lists between $4,032 and $4,679 per service; the median group lists $4,392. Submitted charges are provider-set list amounts, not payments.
Estimated all-Medicare volume estimate
FFS + estimated MA

~187 services

87 observed fee-for-service (47%) · ~100 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
Average charge

$4,504

per service, submitted list amounts — not payments · observed FFS basis
Charge-to-payment ratio

6.1×

average list $4,504 vs average Medicare payment $744 per service · basis-independent
Billing groups

3

3 at the ≥11-service disclosure floor
What they charge

Half the field lists between $4,032 and $4,679

Submitted charges are provider-set list amounts, not payments · median $4,392 (named groups)
Every group, one dot3 billing groups · median $4,392

Each dot is one billing group — 3 of them list this code

$0$2,500$5,000average submitted charge per service, per billing groupmedian $4,392
One dot per billing group, 23470 nationwide CY2024 — average submitted charge per service, provider-set list amounts, not payments. The axis caps near the 95th percentile so the cluster is legible; groups beyond it draw at the cap in accent and are counted on the chart.
Where the market isobserved FFS services by state · CY2024
MEVTNHWAIDMTNDMNWIIL: 18ILMINYMARIORNVWYSDIAINOHPANJCTCAUTCONEMOKYWVVAMDDEAZNMKSARTNNCSCDCOKLAMSAL: 24ALGAHIAKTX: 45TXFL
Shaded low→high on observed fee-for-service services billed from each state · the /stats tile grid, at national scope. Shading ranks the states rather than spacing them along the range, so neighbouring shades mean adjacent RANKS, not equal gaps — the key names the lowest and highest; each tile carries its own figure.

Open a state market: TX · AL · IL — the group ranking lives in the Provider groups tab. Territories bill too; the tile grid draws the 50 states and DC.

Every group in this market, placed by list charge against volume

The whole field, one canvas3 groups · bubble = services
One billing groupOne billing groupOne billing group$500$1,250$2,500$3,750$5,000+Average submitted charge per service — list amounts, not paymentsServices per group — 23470, CY2024
One mark per physician group, 23470 nationwide CY2024 — marks are unnamed here: a mark’s position is its average list charge, and that figure is part of the platform. Submitted charges are provider-set list amounts, not payments.