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

28510 Closed treatment of broken toe CPT · Musculoskeletal procedure

Classification Procedure › Musculoskeletal (CMS RBCS)

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

National scale 472 services ▲ 23.6% YoY · 441 beneficiaries (CY2024, Medicare FFS)

Medicare paid $44K · $92.52 avg / service, national

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

Billing groups

Named-group FFS services

197

FFS of Medicare

49%

Services YoY

+23.6%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~399 services

197 observed fee-for-service (49%) · ~202 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 — 28510 (CY2024)

PA 156 FL 132 NY 38 MA 29 NJ 23

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

Named-group submitted charges

$91K

Named-group allowed amount

$25K

Named-group Medicare payments

$19K

Avg charge / svc

$460

Avg allowed / svc

$125

Avg payment / svc

$96

Average charge per group

$128–195

$195–262

$262–329

$329–396

$396–463

$463–530

$530–597

$597–664

$128 12 groups · avg submitted charge / service $664

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.

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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 28510 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	28510 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	RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II LLC	PHILADELPHIA	PA	PHYSICIAN ASSISTANT	287	42	$27,888	$664	premium	26.9%	(267) 339-3500
2	LEXINGTON HEALTH INC	WEST COLUMBIA	SC	NURSE PRACTITIONER	909	19	$7,049	$371	premium	100.0%	(803) 744-4900
3	SARASOTA FOOT CARE CENTER PA	SARASOTA	PA	PODIATRY	4	17	$2,178	$128	premium	10.9%	(941) 917-6232
4	MASSACHUSETTS GENERAL PHYSICIANS ORGANIZATION INC	BOSTON	MA	DIAGNOSTIC RADIOLOGY	3532	17	$9,387	$552	premium	58.6%	(617) 724-0287
5	FLORIDA FOOT AND ANKLE ASSOCIATES, LLC.	MIAMI	FL	PODIATRY	25	16	$4,212	$263	premium	12.1%	(305) 412-1218
6	ILLINOIS BONE AND JOINT INSTITUTE, LLC	BANNOCKBURN	IL	ORTHOPEDIC SURGERY	595	13	$6,591	$507	premium	100.0%	—
7	MEDICAL ASSOCIATES OF BREVARD LLC	MELBOURNE	FL	NURSE PRACTITIONER	82	13	$4,069	$313	premium	9.8%	(321) 622-8730
8	NORTH SHORE-LIJ MEDICAL PC	MANHASSET	NY	PHYSICIAN ASSISTANT	6294	13	$7,371	$567	premium	34.2%	—
9	CENTEROCK PODIATRY ASSOCIATES, PC	WEST NYACK	NY	PODIATRY	5	13	$5,850	$450	premium	34.2%	(845) 358-2844
10	CERTIFIED FOOT AND ANKLE SPECIALISTS	BOCA RATON	FL	PODIATRY	12	12	$5,700	$475	premium	9.1%	(561) 995-0229
11	PACE FOOT AND ANKLE CENTERS PLLC	ALLENTOWN	PA	PODIATRY	27	11	$2,925	$266	premium	7.1%	(610) 330-9740
12	ROTHMAN ORTHOPAEDICS OF NEW JERSEY, LLC	MARLTON	NJ	PHYSICIAN ASSISTANT	176	11	$7,304	$664	premium	47.8%	(800) 321-9999

*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 →