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

27125 Partial replacement of thigh bone at hip joint with prosthesis CPT · Musculoskeletal procedure

Classification Procedure › Musculoskeletal › Arthroplasty - Hip (CMS RBCS)

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

National scale 343 services ▼ 21.9% YoY · 342 beneficiaries (CY2024, Medicare FFS)

Medicare paid $281K · $818.67 avg / service, national

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

Billing groups

Named-group FFS services

203

FFS of Medicare

49%

Services YoY

-21.9%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~382 services

203 observed fee-for-service (53%) · ~179 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 — 27125 (CY2024)

CA 66 OK 43 IL 42 AZ 37 NJ 25

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

Named-group submitted charges

$1.2M

Named-group allowed amount

$200K

Named-group Medicare payments

$159K

Avg charge / svc

$5,841

Avg allowed / svc

$988

Avg payment / svc

$782

Average charge per group

$2,612–4,772

$4,772–6,932

$6,932–9,092

$9,092–11,251

$11,251–13,411

$13,411–15,571

$15,571–17,731

$17,731+

$2,612 10 groups · avg submitted charge / service $27,553

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.

View the live example →

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 27125 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	27125 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	ORTHO CENTRAL	NORMAN	OK	PHYSICIAN ASSISTANT	32	43	$132,801	$3,088	premium	100.0%	—
2	NORTHWEST ALLIED PHYSICIANS LLC	TUCSON	AZ	PHYSICIAN ASSISTANT	128	37	$102,405	$2,768	premium	100.0%	(520) 202-7770
3	SUTTER VALLEY MEDICAL FOUNDATION	SACRAMENTO	CA	DIAGNOSTIC RADIOLOGY	2420	28	$73,142	$2,612	premium	42.4%	(916) 681-8852
4	SANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC.	SANTA ROSA	LA	ORTHOPEDIC SURGERY	8	22	$66,915	$3,042	premium	100.0%	70754619225507
5	OSF MULTI-SPECIALTY GROUP	PEORIA	IL	NURSE PRACTITIONER	2091	13	$118,560	$9,120	premium	31.0%	(309) 683-5050
6	NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED MAINTAINI	NEW YORK	NY	FAMILY PRACTICE	19	13	$131,365	$10,105	premium	100.0%	(212) 774-7123
7	PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOC OF SOUTHERN NJ LLC	VINELAND	NJ	ORTHOPEDIC SURGERY	38	13	$358,190	$27,553	premium	52.0%	(856) 690-1616
8	TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP	LANGHORNE	NJ	NURSE PRACTITIONER	383	12	$126,300	$10,525	premium	48.0%	—
9	LONGVIEW ORTHOPAEDIC CENTER, LLC	LEOMINSTER	MA	ORTHOPEDIC SURGERY	6	11	$37,450	$3,405	premium	100.0%	(978) 534-6333
10	ROPER SAINT FRANCIS PHYSICIANS NETWORK	CHARLESTON	SC	PHYSICIAN ASSISTANT	539	11	$38,533	$3,503	premium	100.0%	(843) 720-8448

*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 →