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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
27870 Fusion of ankle joint, open procedure CPT · Musculoskeletal procedure
Classification Procedure Musculoskeletal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 103 services ▼ 6.4% YoY · 101 beneficiaries (CY2024, Medicare FFS)
Medicare paid $68K · $657.94 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
4
Named-group FFS services
49
FFS of Medicare
49%
Services YoY
-6.4%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~89 services

49 observed fee-for-service (55%) · ~40 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 — 27870 (CY2024)

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

Named-group submitted charges
$182K
Named-group allowed amount
$43K
Named-group Medicare payments
$34K
Avg charge / svc
$3,713
Avg allowed / svc
$869
Avg payment / svc
$692
Average charge per group
$2,032 4 groups · avg submitted charge / service $5,710
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 27870 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 27870 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 SPRINGFIELD CLINIC, LLP SPRINGFIELD IL NURSE PRACTITIONER 686 15 $85,653 $5,710 premium 39.5% (217) 544-6464
2 CAMPBELL CLINIC, PC GERMANTOWN TN ORTHOPEDIC SURGERY 225 12 $39,456 $3,288 premium 100.0% (901) 759-3100
3 LOYOLA UNIVERSITY MEDICAL CENTER MAYWOOD IL NURSE PRACTITIONER 933 11 $34,452 $3,132 premium 28.9% (708) 216-8372
4 MCBRIDE CLINIC ORTHOPEDIC HOSPITAL, LLC OKLAHOMA CITY OK PHYSICIAN ASSISTANT 103 11 $22,352 $2,032 premium 100.0% (405) 604-6000

*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 →