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

27437 Repair of kneecap CPT · Musculoskeletal procedure

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

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

National scale 240 services ▼ 2.4% YoY · 234 beneficiaries (CY2024, Medicare FFS)

Medicare paid $89K · $369.13 avg / service, national

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

Billing groups

Named groups billing this code

Named-group all-Medicare svcs · est.

375

Scaled from 183 observed FFS services.

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

+0.2%

All-Medicare est. · observed FFS -2.4%

Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.

Estimated all-Medicare volume estimate

FFS + estimated MA

~375 services

183 observed fee-for-service (49%) · ~192 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 — 27437 (CY2024)

CA 150 MO 76 MI 14

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

Billed → allowed → paid

Named-group submitted charges

$661K

Named-group allowed amount

$75K

Named-group Medicare payments

$60K

Avg charge / svc

$3,614

Avg allowed / svc

$409

Avg payment / svc

$326

Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.

Average charge per group

$2,195–3,129

$3,129–4,064

$4,064–4,998

$4,998–5,933

$5,933–6,867

$6,867–7,801

$7,801–8,736

$8,736+

$2,195 2 groups · avg submitted charge / service $10,064

Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — the free tier previews every panel, gated.

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 →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 27437 services, highest first, CY2024
#	Physician group locked column	City locked column	St locked column	Specialty locked column	Providers locked column	27437 svcs	Submitted charges locked column	Avg charge locked column	Medicare $ locked column	Share of state* locked column	Phone
1	GLENDALE ADVENTIST MEDICAL CENTER	GLENDALE	CA	ANESTHESIOLOGY	100	150	$329,250	$2,195	premium	100.0%	(818) 863-4099
2	ORTHOPEDIC ASSOCIATES LLC	SAINT LOUIS	MO	ORTHOPEDIC SURGERY	14	33	$332,101	$10,064	premium	43.4%	(314) 569-0612

*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 →