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

23615 Treatment of broken top of upper arm bone CPT · Musculoskeletal procedure

Classification Procedure › Musculoskeletal (CMS RBCS)

First observed 2013 — start of our 12-year window; the code predates it

National scale 367 services ▼ 4.9% YoY · 359 beneficiaries (CY2024, Medicare FFS)

Medicare paid $195K · $530.64 avg / service, national

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

Billing groups

Named-group FFS services

242

FFS of Medicare

49%

Services YoY

-4.9%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~475 services

242 observed fee-for-service (51%) · ~233 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 — 23615 (CY2024)

FL 156 IA 38 OH 32 MO 23 NY 19

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

Named-group submitted charges

$555K

Named-group allowed amount

$146K

Named-group Medicare payments

$116K

Avg charge / svc

$2,295

Avg allowed / svc

$603

Avg payment / svc

$480

Average charge per group

$1,118–1,513

$1,513–1,908

$1,908–2,303

$2,303–2,699

$2,699–3,094

$3,094–3,489

$3,489–3,884

$3,884+

$1,118 12 groups · avg submitted charge / service $4,850

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 23615 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	23615 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	ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A.	FORT MYERS	FL	PHYSICIAN ASSISTANT	46	48	$115,897	$2,415	premium	30.8%	(239) 334-7000
2	IOWA ORTHOPAEDIC CENTER PC	DES MOINES	IA	PHYSICIAN ASSISTANT	69	38	$59,314	$1,561	premium	100.0%	(515) 247-8400
3	FORT PIERCE ORTHOPAEDICS LLC	FORT PIERCE	FL	PHYSICIAN ASSISTANT	19	23	$73,275	$3,186	premium	14.7%	(772) 465-4651
4	GARNET HEALTH DOCTORS PC	MIDDLETOWN	NY	HOSPITALIST	170	19	$33,003	$1,737	premium	100.0%	(845) 333-7575
5	ARKANSAS HEALTH GROUP	LITTLE ROCK	AR	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)	666	15	$30,150	$2,010	premium	100.0%	(501) 202-2093
6	MERCY HEALTH PHYSICIANS CINCINNATI SPECIALTY CARE LLC	CINCINNATI	OH	NURSE PRACTITIONER	347	15	$21,690	$1,446	premium	46.9%	(513) 751-4222
7	GARNET HEALTH DOCTORS PC	MIDDLETOWN	PA	HOSPITALIST	170	14	$3,884	$277	premium	100.0%	(845) 333-7575
8	ORTHOLONESTAR PLLC	DALLAS	TX	PHYSICIAN ASSISTANT	407	12	$33,576	$2,798	premium	100.0%	(214) 220-2468
9	PENINSULA ORTHOPAEDIC ASSOC PA	SALISBURY	MD	PHYSICIAN ASSISTANT	57	12	$28,872	$2,406	premium	100.0%	(410) 749-4154
10	ILLINOIS BONE AND JOINT INSTITUTE, LLC	BANNOCKBURN	IL	ORTHOPEDIC SURGERY	595	12	$45,754	$3,813	premium	100.0%	—
11	FIRST CHOICE PHYSICIAN PARTNERS	PALM SPRINGS	CA	PHYSICIAN ASSISTANT	148	12	$29,892	$2,491	premium	100.0%	—
12	ROTHMAN ORTHOPAEDICS OF NEW JERSEY, LLC	MARLTON	NJ	PHYSICIAN ASSISTANT	176	11	$53,350	$4,850	premium	100.0%	(800) 321-9999
13	ADVANCED ORTHOPAEDIC ASSOCIATES, P.A.	WELLINGTON	KS	ORTHOPEDIC SURGERY	48	11	$26,819	$2,438	premium	100.0%	(316) 631-1600

*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 →