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

38746 Removal of lymph nodes of chest cavity and breast bone CPT · Other Organ Systems procedure

Classification Procedure › Other Organ Systems (CMS RBCS)

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

National scale 472 services ▼ 2.1% YoY · 471 beneficiaries (CY2024, Medicare FFS)

Medicare paid $62K · $132.31 avg / service, national

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

Billing groups

Named-group FFS services

404

FFS of Medicare

49%

Services YoY

-2.1%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~825 services

404 observed fee-for-service (49%) · ~421 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 — 38746 (CY2024)

MO 68 PA 61 MN 48 CA 40 TX 40

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

Named-group submitted charges

$519K

Named-group allowed amount

$70K

Named-group Medicare payments

$56K

Avg charge / svc

$1,286

Avg allowed / svc

$173

Avg payment / svc

$138

Average charge per group

$188–600

$600–1,011

$1,011–1,423

$1,423–1,835

$1,835–2,246

$2,246–2,658

$2,658–3,070

$3,070+

$188 15 groups · avg submitted charge / service $5,190

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.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 38746 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	38746 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	UNIVERSITY OF PENN - MEDICAL GROUP	PHILADELPHIA	PA	PHYSICIAN ASSISTANT	3505	61	$54,290	$890	premium	100.0%	(215) 662-2777
2	MINNESOTA ONCOLOGY HEMATOLOGY PA	EDINA	MN	PHYSICIAN ASSISTANT	135	48	$35,232	$734	premium	100.0%	(952) 928-2900
3	PHYSICIANS REFERRAL SERVICE	HOUSTON	TX	NURSE PRACTITIONER	2696	40	$109,978	$2,749	premium	100.0%	(713) 592-5433
4	EISENHOWER MEDICAL CENTER	RANCHO MIRAGE	CA	NURSE PRACTITIONER	457	40	$22,000	$550	premium	100.0%	(760) 340-3911
5	WASHINGTON UNIVERSITY	SAINT LOUIS	MO	NURSE PRACTITIONER	3070	38	$197,220	$5,190	premium	55.9%	(314) 747-3000
6	MERCY CLINIC CARDIOVASCULAR AND THORACIC SURGERY LLC	SAINT LOUIS	MO	PHYSICIAN ASSISTANT	23	30	$20,220	$674	premium	44.1%	(314) 251-6970
7	NORTH MISSISSIPPI MEDICAL CENTER, INC.	TUPELO	MS	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)	361	24	$13,410	$559	premium	100.0%	(662) 377-3258
8	OHH PHYSICIANS LLC	OKLAHOMA CITY	OK	INTERVENTIONAL CARDIOLOGY	134	23	$16,583	$721	premium	100.0%	(405) 608-3800
9	LAFAYETTE HEALTH VENTURES INC	LAFAYETTE	LA	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)	293	19	$11,096	$584	premium	61.3%	(337) 289-7374
10	HEART HOSPITAL OF SOUTH DAKOTA LLC	SIOUX FALLS	SD	NURSE PRACTITIONER	67	15	$2,817	$188	premium	100.0%	(605) 977-7000
11	COMMUNITY PHYSICIANS OF INDIANA INC	INDIANAPOLIS	IN	PHYSICIAN ASSISTANT	1594	15	$7,326	$488	premium	53.6%	—
12	CENTRA MEDICAL GROUP LLC	LYNCHBURG	VA	NURSE PRACTITIONER	714	14	$5,894	$421	premium	53.8%	(434) 947-3033
13	JORDAN PHYSICIAN ASSOCIATES INC	PLYMOUTH	MA	NURSE PRACTITIONER	166	13	$11,532	$887	premium	100.0%	(508) 210-5920
14	SENTARA MEDICAL GROUP	NORFOLK	VA	PHYSICIAN ASSISTANT	1404	12	$4,768	$397	premium	46.2%	—
15	LOUISIANA ORTHOPAEDIC SPECIALISTS LLC	LAFAYETTE	LA	PHYSICIAN ASSISTANT	68	12	$7,008	$584	premium	38.7%	(337) 235-8007

*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 →