Medicare procedure market data by CPT code & state

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

48153 Near total removal of pancreas, bile duct, and small bowel with connection of pancreas to small bowel CPT · Procedure

Classification Procedure › Digestive/Gastrointestinal (CMS RBCS)

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

National scale 217 services ▼ 17.2% YoY · 217 beneficiaries (CY2024, Medicare FFS)

Medicare paid $455K · $2097.16 avg / service, national

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

Billing groups

Named-group FFS services

217

FFS of Medicare

49%

Services YoY

-17.2%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~390 services

217 observed fee-for-service (56%) · ~173 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 — 48153 (CY2024)

IL 84 PA 28 MD 26 CA 22 FL 17

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

Named-group submitted charges

$2.1M

Named-group allowed amount

$570K

Named-group Medicare payments

$455K

Avg charge / svc

$9,697

Avg allowed / svc

$2,625

Avg payment / svc

$2,097

Average charge per group

$5,626–7,664

$7,664–9,701

$9,701–11,739

$11,739–13,776

$13,776–15,814

$15,814–17,852

$17,852–19,889

$19,889+

$5,626 10 groups · avg submitted charge / service $22,195

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.

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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 48153 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	48153 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	ENDEAVOR HEALTH MEDICAL GROUP	EVANSTON	IL	NURSE PRACTITIONER	3380	84	$472,601	$5,626	premium	100.0%	—
2	UNIVERSITY OF MARYLAND ST JOSEPH MEDICAL GROUP LLC	TOWSON	MD	NURSE PRACTITIONER	292	26	$148,267	$5,703	premium	100.0%	(410) 337-4877
3	MAYO CLINIC JACKSONVILLE	JACKSONVILLE	FL	NURSE PRACTITIONER	1587	17	$301,766	$17,751	premium	100.0%	(904) 953-2000
4	MEDICAL FACULTY ASSOCIATES, INC	WASHINGTON	DC	PHYSICIAN ASSISTANT	685	16	$122,656	$7,666	premium	100.0%	(202) 715-4000
5	JEFFERSON UNIVERSITY PHYSICIANS	PHILADELPHIA	PA	DIAGNOSTIC RADIOLOGY	1570	15	$115,500	$7,700	premium	53.6%	—
6	MSKCC SURGERY GROUP	NEW YORK	PA	PHYSICIAN ASSISTANT	373	13	$288,535	$22,195	premium	46.4%	(212) 639-2000
7	HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC	BOSTON	MA	INTERNAL MEDICINE	1689	12	$169,117	$14,093	premium	100.0%	(781) 983-9088
8	EVANSVILLE SURGICAL ASSOCIATES INC	EVANSVILLE	IN	PHYSICIAN ASSISTANT	45	12	$75,600	$6,300	premium	100.0%	(812) 424-8231
9	THE REGENTS OF THE UNIVERSITY OF CALIFORNIA	LOS ANGELES	CA	SURGICAL ONCOLOGY	14	11	$237,585	$21,599	premium	50.0%	(310) 390-4099
10	STANFORD HEALTH CARE	STANFORD	CA	DIAGNOSTIC RADIOLOGY	3039	11	$172,546	$15,686	premium	50.0%	(650) 723-4000

*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 →