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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
27278 Fusion of pelvic joint including joint implant using imaging guidance CPT · Musculoskeletal procedure
Classification Procedure Musculoskeletal (CMS RBCS)
First observed 2024
National scale 847 services · 757 beneficiaries (CY2024, Medicare FFS)
Medicare paid $4.7M · $5512.37 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
14
Named-group FFS services
267
FFS of Medicare
49%
Services YoY
Estimated all-Medicare volume FFS + estimated MA estimate
~525 services

267 observed fee-for-service (51%) · ~258 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 — 27278 (CY2024)

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

Named-group submitted charges
$2.9M
Named-group allowed amount
$269K
Named-group Medicare payments
$214K
Avg charge / svc
$11,002
Avg allowed / svc
$1,008
Avg payment / svc
$801
Average charge per group
$159 14 groups · avg submitted charge / service $75,072
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 27278 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 27278 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 SPINE CENTER OF SOUTHEAST GEORGIA LLC BRUNSWICK GA PHYSICIAN ASSISTANT 4 30 $46,200 $1,540 premium 38.5% 9122626552107
2 SC PAIN AND SPINE SPECIALISTS, LLC MURRELLS INLET SC NURSE PRACTITIONER 6 29 $949,750 $32,750 premium 49.2% (843) 839-7246
3 VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC DEL NORTE CO FAMILY PRACTICE 21 28 $42,000 $1,500 premium 22.4%
4 KANSAS UNIVERSITY PHYSICIANS INC KANSAS CITY KS NURSE PRACTITIONER 1815 25 $27,631 $1,105 premium 41.7% (913) 588-1227
5 POUDRE VALLEY MEDICAL GROUP LLC COLORADO SPRINGS CO PHYSICIAN ASSISTANT 2390 23 $364,331 $15,840 premium 18.4%
6 THS PHYSICIAN PARTNERS INC SOUTH CHARLESTON WV PHYSICIAN ASSISTANT 342 23 $31,488 $1,369 premium 100.0% (304) 400-4545
7 SAINTS MEDICAL GROUP, LLC OKLAHOMA CITY OK PHYSICIAN ASSISTANT 435 22 $24,500 $1,114 premium 18.8%
8 TRICITY PAIN ASSOCIATES, PA SAN ANTONIO TX PHYSICIAN ASSISTANT 23 14 $54,504 $3,893 premium 17.5%
9 ST MARYS GENERAL MEDICAL GROUP PC PASSAIC NJ ANESTHESIOLOGY 74 14 $93,351 $6,668 premium 50.0% (973) 365-4300
10 PAIN PHYSICIANS OF WISCONSIN SC MILWAUKEE WI NURSE PRACTITIONER 28 13 $45,169 $3,475 premium 40.6% (262) 297-7246
11 SOUTHERN PAIN AND ANESTHESIA CONSULTANTS, LLC MARRERO LA PHYSICIAN ASSISTANT 4 12 $47,124 $3,927 premium 100.0% (504) 887-7207
12 AVENSTAR PAIN SPECIALISTS PLLC MIDWEST CITY OK NURSE PRACTITIONER 3 12 $384,000 $32,000 premium 10.3% (405) 438-0913
13 JOINT IMPLANT SURGEONS OF FLORIDA PA FORT MYERS FL PHYSICIAN ASSISTANT 26 11 $1,749 $159 premium 6.6% (239) 337-2003
14 ILLINOIS PAIN TREATMENT INSTITUTE LTD BARRINGTON IL PHYSICIAN ASSISTANT 10 11 $825,788 $75,072 premium 44.0% (847) 852-2000

*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 →