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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
23474 Revision of total shoulder repair, total shoulder 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 827 services ▲ 16.3% YoY · 766 beneficiaries (CY2024, Medicare FFS)
Medicare paid $894K · $1080.94 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
25
Named-group FFS services
481
FFS of Medicare
49%
Services YoY
+16.3%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~1,027 services

481 observed fee-for-service (47%) · ~546 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 — 23474 (CY2024)

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

Named-group submitted charges
$4.0M
Named-group allowed amount
$603K
Named-group Medicare payments
$480K
Avg charge / svc
$8,358
Avg allowed / svc
$1,254
Avg payment / svc
$998
Average charge per group
$992 25 groups · avg submitted charge / service $35,000
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 23474 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 23474 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 CEDARS-SINAI MEDICAL CARE FOUNDATION LOS ANGELES CA PHYSICIAN ASSISTANT 1699 39 $250,555 $6,424 premium 33.3% (310) 423-0674
2 ORTHOLONESTAR PLLC DALLAS TX PHYSICIAN ASSISTANT 407 36 $97,654 $2,713 premium 50.7% (214) 220-2468
3 COLUMBIA ORTHOPAEDIC GROUP LLP COLUMBIA MO ORTHOPEDIC SURGERY 91 34 $112,317 $3,303 premium 72.3% (573) 443-2402
4 MAYO CLINIC ROCHESTER MN NURSE PRACTITIONER 4896 29 $332,412 $11,462 premium 100.0% (507) 284-2511
5 ORTHOPAEDIC ASSOCIATES OF WISCONSIN SC PEWAUKEE WI PHYSICIAN ASSISTANT 100 27 $228,100 $8,448 premium 64.3% (262) 303-5055
6 ST. VINCENT'S ORTHOPEDICS, PC BIRMINGHAM AL PHYSICIAN ASSISTANT 16 22 $76,538 $3,479 premium 100.0% (205) 933-7838
7 CENTRAL CALIFORNIA FACULTY MEDICAL GROUP INC FRESNO CA EMERGENCY MEDICINE 252 20 $30,522 $1,526 premium 17.1% (559) 459-6000
8 HSS-FLORIDA PHYSICIANS LLC WEST PALM BEACH FL DIAGNOSTIC RADIOLOGY 60 20 $157,500 $7,875 premium 14.2% (561) 657-4600
9 ORTHOPEDIC INSTITUTE OF NEWPORT BEACH LIMITED PARTNERSHIP NEWPORT BEACH CA PHYSICIAN ASSISTANT 30 20 $102,754 $5,138 premium 17.1% (949) 722-7038
10 UPSTATE ORTHOPEDICS, LLP CAMILLUS NY ORTHOPEDIC SURGERY 34 20 $107,120 $5,356 premium 40.0% (315) 551-6000
11 NEW YORK UNIVERSITY NEW YORK NY DIAGNOSTIC RADIOLOGY 5704 19 $503,386 $26,494 premium 38.0% (212) 263-9700
12 ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND NEW ORLEANS LA INTERNAL MEDICINE 412 17 $71,053 $4,180 premium 100.0%
13 UNIVERSITY MEDICAL ASSOCIATES OF THE MEDICAL UNIVERSITY OF SOUTH CAROL CHARLESTON SC PHYSICIAN ASSISTANT 1692 16 $402,095 $25,131 premium 100.0% (843) 792-1414
14 OSF MULTI-SPECIALTY GROUP PEORIA WI NURSE PRACTITIONER 2091 15 $30,031 $2,002 premium 35.7% (309) 683-5050
15 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 15 $159,174 $10,612 premium 37.5%
16 FORT WORTH BRAIN AND SPINE INSTITUTE, LLP FORT WORTH TX NEUROSURGERY 11 15 $14,880 $992 premium 21.1% (817) 878-5333
17 ORTHOMIDWEST, PLLC CHICAGO IL PHYSICIAN ASSISTANT 542 15 $310,835 $20,722 premium 32.6% (877) 632-6637
18 NORTHEAST ORTHOPAEDIC ALLIANCE PLLC CONCORD MA PHYSICIAN ASSISTANT 268 14 $490,000 $35,000 premium 100.0% (603) 883-0091
19 THE ASSOCIATION OF UNIVERSITY PHYSICIANS SEATTLE WA PHYSICIAN ASSISTANT 3612 14 $63,846 $4,560 premium 56.0% (206) 364-0500
20 BASS MEDICAL GROUP WALNUT CREEK CA OTOLARYNGOLOGY 318 13 $62,036 $4,772 premium 11.1%
21 CRYSTAL CLINIC, INC. CUYAHOGA FALLS OH PHYSICIAN ASSISTANT 45 13 $67,531 $5,195 premium 32.5% (330) 929-9136
22 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 13 $112,144 $8,626 premium 11.1% (650) 723-4000
23 OSU INTERNAL MEDICINE LLC COLUMBUS OH NURSE PRACTITIONER 1155 12 $72,956 $6,080 premium 30.0% (614) 293-8000
24 FLORIDA CLINICAL PRACTICE ASSOCIATION INC GAINESVILLE FL NURSE PRACTITIONER 1912 12 $123,144 $10,262 premium 8.5% (352) 265-8990
25 KADLEC REGIONAL MEDICAL CENTER RICHLAND WA PHYSICIAN ASSISTANT 382 11 $41,525 $3,775 premium 44.0% (509) 946-4611

*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 →