Medicare procedure market data by CPT code & state

+ Build a code basket

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

27430 Repair of muscle group above knee joint CPT · Musculoskeletal procedure

Classification Procedure › Musculoskeletal (CMS RBCS)

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

National scale 521 services ▲ 63.8% YoY · 468 beneficiaries (CY2024, Medicare FFS)

Medicare paid $134K · $256.67 avg / service, national

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

Billing groups

Named-group FFS services

264

FFS of Medicare

49%

Services YoY

+63.8%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~564 services

264 observed fee-for-service (47%) · ~300 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 — 27430 (CY2024)

TX 259 FL 136 MT 35 CA 27 WA 14

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

Named-group submitted charges

$662K

Named-group allowed amount

$77K

Named-group Medicare payments

$62K

Avg charge / svc

$2,509

Avg allowed / svc

$293

Avg payment / svc

$234

Average charge per group

$563–1,339

$1,339–2,116

$2,116–2,892

$2,892–3,668

$3,668–4,445

$4,445–5,221

$5,221–5,997

$5,997+

$563 14 groups · avg submitted charge / service $11,113

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.

Notify me at launch →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 27430 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	27430 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	TEXAS JOINT INSTITUTE, PLLC	DALLAS	TX	PHYSICIAN ASSISTANT	39	59	$83,594	$1,417	premium	22.8%	(972) 566-5255
2	BAPTIST HEALTH MEDICAL GROUP ORTHOPEDICS, LLC	CORAL GABLES	FL	PHYSICIAN ASSISTANT	68	31	$137,547	$4,437	premium	22.8%	(786) 268-6200
3	SUMMIT MEMORIAL MEDICAL GROUP LLC	CASPER	TX	PHYSICIAN ASSISTANT	39	16	$19,328	$1,208	premium	6.2%	(307) 358-2122
4	NEW YORK UNIVERSITY	NEW YORK	CA	DIAGNOSTIC RADIOLOGY	5704	15	$166,695	$11,113	premium	55.6%	(212) 263-9700
5	ORTHO MONTANA, PSC	BILLINGS	MT	PHYSICIAN ASSISTANT	39	14	$7,882	$563	premium	40.0%	(406) 237-5050
6	INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC	GRAND JUNCTION	MI	PHYSICIAN ASSISTANT	294	14	$23,306	$1,665	premium	100.0%	(970) 242-3535
7	SACRED HEART HEALTH SYSTEM INC	PENSACOLA	FL	NURSE PRACTITIONER	371	14	$31,990	$2,285	premium	10.3%	(850) 416-2400
8	PROVIDENCE HEALTH AND SERVICES WASHINGTON	SPOKANE	WA	PHYSICIAN ASSISTANT	771	14	$32,228	$2,302	premium	100.0%	—
9	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO	SAN ANTONIO	TX	PHYSICIAN ASSISTANT	1326	14	$30,546	$2,182	premium	5.4%	(210) 450-7044
10	ORTHOLONESTAR PLLC	DALLAS	TX	PHYSICIAN ASSISTANT	407	13	$15,556	$1,197	premium	5.0%	(214) 220-2468
11	HIP AND JOINT SPECIALISTS OF NORTH TEXAS PLLC	FRISCO	TX	ORTHOPEDIC SURGERY	7	13	$29,815	$2,293	premium	5.0%	(469) 310-4400
12	METHODIST PHYSICIAN PRACTICES PLLC	SAN ANTONIO	TX	INTERVENTIONAL CARDIOLOGY	169	12	$24,681	$2,057	premium	4.6%	(210) 575-8289
13	CHI HEALTH CLINIC SPECIALTY LLC	LINCOLN	NV	NURSE PRACTITIONER	309	12	$17,175	$1,431	premium	100.0%	(402) 219-8000
14	UNIVERSITY OF MIAMI	MIAMI	FL	NURSE PRACTITIONER	2331	12	$38,350	$3,196	premium	8.8%	(305) 689-5437
15	INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC	GRAND JUNCTION	CO	PHYSICIAN ASSISTANT	294	11	$3,662	$333	premium	100.0%	(970) 242-3535

*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 →