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

45560 Repair of bulging of rectum into vagina CPT · Procedure

Classification Procedure › Digestive/Gastrointestinal (CMS RBCS)

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

National scale 432 services ▼ 16.9% YoY · 432 beneficiaries (CY2024, Medicare FFS)

Medicare paid $112K · $258.12 avg / service, national

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

Billing groups

Named groups billing this code

Named-group FFS services

282

Attributable volume · fee-for-service

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

-16.9%

FFS enrollment -2.2%

Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.

Estimated all-Medicare volume estimate

FFS + estimated MA

~596 services

282 observed fee-for-service (47%) · ~314 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 — 45560 (CY2024)

TX 167 FL 92 GA 57 NY 35 NJ 28

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

Billed → allowed → paid

Named-group submitted charges

$564K

Named-group allowed amount

$95K

Named-group Medicare payments

$76K

Avg charge / svc

$2,001

Avg allowed / svc

$338

Avg payment / svc

$269

Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.

Average charge per group

$1,248–1,441

$1,441–1,633

$1,633–1,826

$1,826–2,018

$2,018–2,211

$2,211–2,403

$2,403–2,596

$2,596+

$1,248 9 groups · avg submitted charge / service $3,000

Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — the free tier previews every panel, gated.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 45560 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	45560 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	AUSTIN UROGYNECOLOGY, PLLC	AUSTIN	TX	NURSE PRACTITIONER	3	68	$84,890	$1,248	premium	40.7%	(512) 973-8276
2	ST. JOSEPH'S/CANDLER OB/GYN PRACTICE, LLC	SAVANNAH	GA	OBSTETRICS/GYNECOLOGY	21	57	$118,275	$2,075	premium	100.0%	(912) 355-5755
3	INSTITUTE FOR WOMEN'S HEALTH AND BODY LLC	WEST PALM BEACH	FL	OBSTETRICS/GYNECOLOGY	49	41	$101,277	$2,470	premium	44.6%	(561) 616-9988
4	UNIFIED WOMENS HEALTHCARE OF TEXAS PLLC	MCKINNEY	TX	OBSTETRICS/GYNECOLOGY	184	30	$63,940	$2,131	premium	18.0%	(972) 542-8884
5	HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC	NEPTUNE	NJ	NURSE PRACTITIONER	1878	28	$63,377	$2,263	premium	100.0%	(732) 362-3663
6	MAYO CLINIC JACKSONVILLE	JACKSONVILLE	FL	NURSE PRACTITIONER	1587	18	$38,532	$2,141	premium	19.6%	(904) 953-2000
7	NORTH SHORE UROGYNECOLOGY LTD	LAKE FOREST	IL	UROLOGY	2	17	$51,000	$3,000	premium	100.0%	(847) 234-1100
8	JEFFERSON UNIVERSITY PHYSICIANS	PHILADELPHIA	PA	DIAGNOSTIC RADIOLOGY	1570	12	$21,120	$1,760	premium	48.0%	—
9	CONRAD PEARSON CLINIC PC	SOUTHAVEN	TN	UROLOGY	21	11	$22,000	$2,000	premium	100.0%	(662) 349-1964

*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 →