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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
28730 Fusion of multiple foot joints CPT · Musculoskeletal procedure
Classification Procedure Musculoskeletal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 383 services ▼ 31.4% YoY · 380 beneficiaries (CY2024, Medicare FFS)
Medicare paid $741K · $1934.58 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
9
Named-group FFS services
171
FFS of Medicare
49%
Services YoY
-31.4%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~353 services

171 observed fee-for-service (48%) · ~182 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 — 28730 (CY2024)

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

Named-group submitted charges
$448K
Named-group allowed amount
$85K
Named-group Medicare payments
$67K
Avg charge / svc
$2,618
Avg allowed / svc
$495
Avg payment / svc
$391
Average charge per group
$1,288 9 groups · avg submitted charge / service $4,407
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 28730 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 28730 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 CENTER FOR ORTHOPEDIC SURGERY L.L.P. LUBBOCK TX ORTHOPEDIC SURGERY 13 26 $39,443 $1,517 premium 100.0% (806) 797-4985
2 COLUMBIA ORTHOPAEDIC GROUP LLP COLUMBIA MO ORTHOPEDIC SURGERY 91 24 $30,915 $1,288 premium 100.0% (573) 443-2402
3 MICHIGAN ORTHOPAEDIC SURGEONS PLLC BEVERLY HILLS MI PHYSICIAN ASSISTANT 124 23 $53,314 $2,318 premium 40.4% (248) 644-3920
4 ORTHOARKANSAS PA LITTLE ROCK AR PHYSICAL THERAPIST IN PRIVATE PRACTICE 145 22 $49,500 $2,250 premium 100.0% (501) 500-3500
5 SPRINGFIELD CLINIC, LLP SPRINGFIELD IL NURSE PRACTITIONER 686 22 $96,947 $4,407 premium 26.5% (217) 544-6464
6 ORTHOMIDWEST, PLLC CHICAGO IL PHYSICIAN ASSISTANT 542 16 $65,750 $4,109 premium 19.3% (877) 632-6637
7 MERCY HEALTH PHYSICIANS KENTUCKY SPECIALTY CARE LLC PADUCAH KY NURSE PRACTITIONER 142 15 $46,062 $3,071 premium 100.0%
8 HH HEALTH SYSTEM - THE ORTHOPAEDIC CENTER LLC HUNTSVILLE AL PHYSICAL THERAPIST IN PRIVATE PRACTICE 175 12 $33,520 $2,793 premium 100.0% (256) 539-2728
9 VANN-VIRGINIA CENTER FOR ORTHOPAEDICS PC VIRGINIA BEACH VA PHYSICIAN ASSISTANT 67 11 $32,276 $2,934 premium 100.0% (757) 321-3300

*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 →