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Market snapshot

46940 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

46940 — Initial repair of anal tear with dilation of anal muscle

Billing groups
4
Named-group FFS services
129
FFS of Medicare
49%
Services YoY
+20.6%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~258 services

129 observed fee-for-service (50%) · ~129 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 — 46940 (CY2024)

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

Named-group submitted charges
$115K
Named-group allowed amount
$37K
Named-group Medicare payments
$29K
Avg charge / svc
$889
Avg allowed / svc
$287
Avg payment / svc
$226
Average charge per group
$656 4 groups · avg submitted charge / service $950
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 46940 services, CY2024
#Physician group City St Specialty Providers 46940 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 NORTH SHORE MEDICAL GROUP OF THE MOUNT SINAI SCHOOL OF MEDICINE GREENLAWN NY DIAGNOSTIC RADIOLOGY 315 70 $66,500 $950 premium 49.0% (631) 628-5000
2 PRACTICE ASSOCIATES MEDICAL GROUP MORRISTOWN NJ NURSE PRACTITIONER 1404 30 $26,130 $871 premium 100.0% (973) 971-5596
3 PECONIC BAY PRIMARY MEDICAL CARE RIVERHEAD NY PHYSICIAN ASSISTANT 71 18 $14,886 $827 premium 12.6% (631) 727-1600
4 WHEELING HOSPITAL INC WHEELING WV NURSE PRACTITIONER 418 11 $7,216 $656 premium 100.0% (304) 243-3000

*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 →