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

42415 Removal of growth of saliva gland with release of facial nerve 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 413 services ▼ 9.6% YoY · 410 beneficiaries (CY2024, Medicare FFS)

Medicare paid $270K · $652.98 avg / service, national

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

Billing groups

Named-group FFS services

365

FFS of Medicare

49%

Services YoY

-9.6%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~749 services

365 observed fee-for-service (49%) · ~384 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 — 42415 (CY2024)

FL 97 TX 71 AZ 52 AR 44 PA 28

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

Named-group submitted charges

$1.4M

Named-group allowed amount

$296K

Named-group Medicare payments

$235K

Avg charge / svc

$3,882

Avg allowed / svc

$811

Avg payment / svc

$643

Average charge per group

$1,094–1,753

$1,753–2,413

$2,413–3,073

$3,073–3,732

$3,732–4,392

$4,392–5,052

$5,052–5,712

$5,712+

$1,094 16 groups · avg submitted charge / service $6,390

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 42415 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	42415 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	MAYO CLINIC JACKSONVILLE	JACKSONVILLE	FL	NURSE PRACTITIONER	1587	57	$325,680	$5,714	premium	58.8%	(904) 953-2000
2	CENTRAL ARKANSAS RADIATION THERAPY INSTITUTE INC	LITTLE ROCK	AR	HEMATOLOGY/ONCOLOGY	90	44	$128,348	$2,917	premium	100.0%	—
3	MAYO CLINIC ARIZONA	PHOENIX	AZ	PHYSICIAN ASSISTANT	1635	40	$194,810	$4,870	premium	76.9%	(800) 603-0558
4	TEXAS HEALTH CARE PLLC	FORT WORTH	TX	NURSE PRACTITIONER	364	32	$92,140	$2,879	premium	45.1%	(817) 920-0484
5	EAR NOSE AND THROAT SPECIALTY CARE PLLC	DALLAS	TX	OTOLARYNGOLOGY	8	25	$27,338	$1,094	premium	35.2%	(214) 826-3681
6	KANSAS UNIVERSITY PHYSICIANS INC	KANSAS CITY	KS	NURSE PRACTITIONER	1815	23	$58,340	$2,537	premium	100.0%	(913) 588-1227
7	UNIVERSITY OF PENN - MEDICAL GROUP	PHILADELPHIA	PA	PHYSICIAN ASSISTANT	3505	16	$101,840	$6,365	premium	57.1%	(215) 662-2777
8	SANFORD MEDICAL CENTER FARGO	FARGO	ND	NURSE PRACTITIONER	1198	15	$47,891	$3,193	premium	100.0%	(701) 234-2000
9	PRECISION HEALTHCARE SPECIALISTS, LLC	FORT MYERS	FL	PHYSICIAN ASSISTANT	100	15	$33,328	$2,222	premium	15.5%	(239) 291-6970
10	CHRISTUS TRINITY CLINIC	TYLER	TX	NURSE PRACTITIONER	1495	14	$52,908	$3,779	premium	19.7%	(903) 606-5560
11	MASSACHUSETTS EYE AND EAR ASSOCIATES, INC	BOSTON	MA	OPHTHALMOLOGY	406	13	$59,954	$4,612	premium	100.0%	(617) 523-7900
12	SMH PHYSICIAN SERVICES INC	SARASOTA	FL	PHYSICIAN ASSISTANT	766	13	$28,743	$2,211	premium	13.4%	—
13	GENESISCARE USA OF FLORIDA LLC	CAPE CORAL	FL	UROLOGY	175	12	$46,074	$3,840	premium	12.4%	—
14	NORTON HOSPITALS, INC	LOUISVILLE	NC	NURSE PRACTITIONER	136	12	$27,968	$2,331	premium	100.0%	(502) 629-2500
15	COASTAL CAROLINA OTOLARYNGOLOGY ASSOCIATES, PA	MYRTLE BEACH	MN	OTOLARYNGOLOGY	7	12	$51,239	$4,270	premium	52.2%	(843) 449-6449
16	MAYO CLINIC	ROCHESTER	MN	NURSE PRACTITIONER	4896	11	$70,290	$6,390	premium	47.8%	(507) 284-2511
17	UNIVERSITY OF PENN - MEDICAL GROUP	PHILADELPHIA	SC	PHYSICIAN ASSISTANT	3505	11	$70,015	$6,365	premium	100.0%	(215) 662-2777

*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 →