Medicare procedure market data by CPT code & state

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Market snapshot

45303 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

45303 — Dilation of rectum and/or lower large bowel using an endoscope

Billing groups

Named-group FFS services

315

FFS of Medicare

49%

Services YoY

-0.2%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~688 services

315 observed fee-for-service (46%) · ~373 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 — 45303 (CY2024)

NC 285 NY 109 NJ 30

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

Named-group submitted charges

$620K

Named-group allowed amount

$256K

Named-group Medicare payments

$196K

Avg charge / svc

$1,969

Avg allowed / svc

$814

Avg payment / svc

$622

Average charge per group

$1,800–2,011

$2,011–2,221

$2,221–2,432

$2,432–2,642

$2,642–2,853

$2,853–3,063

$3,063–3,274

$3,274+

$1,800 2 groups · avg submitted charge / service $3,573

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 exact payer split, and this market total scaled to all of Medicare, labeled as an estimate.

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 45303 services, CY2024
#	Physician group	City	St	Specialty	Providers	45303 svcs	Submitted charges	Avg charge	Medicare $ locked column	Share*	Phone
1	CAROLINA COLORECTAL SURGERY, PC	RALEIGH	NC	PHYSICIAN ASSISTANT	2	285	$513,000	$1,800	premium	100.0%	(919) 784-6600
2	PRACTICE ASSOCIATES MEDICAL GROUP	MORRISTOWN	NJ	NURSE PRACTITIONER	1404	30	$107,190	$3,573	premium	100.0%	(973) 971-5596

*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 →