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

49423 Exchange of abdominal cavity drainage tube using imaging guidance CPT · Procedure

Classification Procedure › Digestive/Gastrointestinal (CMS RBCS)

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

National scale 945 services ▼ 30.1% YoY · 725 beneficiaries (CY2024, Medicare FFS)

Medicare paid $45K · $47.75 avg / service, national

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

Billing groups

Named-group FFS services

555

FFS of Medicare

49%

Services YoY

-30.1%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~1,192 services

555 observed fee-for-service (47%) · ~637 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 — 49423 (CY2024)

MN 258 CA 213 WI 100 NJ 95 MO 62

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

Named-group submitted charges

$763K

Named-group allowed amount

$34K

Named-group Medicare payments

$26K

Avg charge / svc

$1,375

Avg allowed / svc

$61

Avg payment / svc

$48

Average charge per group

$237–649

$649–1,062

$1,062–1,474

$1,474–1,886

$1,886–2,299

$2,299–2,711

$2,711–3,123

$3,123+

$237 11 groups · avg submitted charge / service $3,837

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 49423 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	49423 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	ROCHESTER	MN	NURSE PRACTITIONER	4896	244	$293,112	$1,201	premium	94.6%	(507) 284-2511
2	COOPER UNIVERSITY RADIOLOGY PC	CAMDEN	NJ	DIAGNOSTIC RADIOLOGY	68	95	$183,635	$1,933	premium	100.0%	—
3	WASHINGTON UNIVERSITY	SAINT LOUIS	MO	NURSE PRACTITIONER	3070	62	$32,922	$531	premium	100.0%	(314) 747-3000
4	FAIRFAX RADIOLOGICAL CONSULTANTS	ALEXANDRIA	VA	DIAGNOSTIC RADIOLOGY	150	25	$95,925	$3,837	premium	64.1%	(703) 698-4444
5	ENDEAVOR HEALTH MEDICAL GROUP	EVANSTON	IL	NURSE PRACTITIONER	3380	22	$5,214	$237	premium	47.8%	—
6	UNMC PHYSICIANS	OMAHA	TX	PHYSICIAN ASSISTANT	1514	19	$11,685	$615	premium	100.0%	(402) 559-4000
7	MAYO CLINIC JACKSONVILLE	JACKSONVILLE	FL	NURSE PRACTITIONER	1587	18	$43,435	$2,413	premium	100.0%	(904) 953-2000
8	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	CA	INTERNAL MEDICINE	3716	17	$54,983	$3,234	premium	8.0%	(415) 600-1020
9	UNMC PHYSICIANS	OMAHA	NE	PHYSICIAN ASSISTANT	1514	15	$9,225	$615	premium	53.6%	(402) 559-4000
10	UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC	MADISON	WI	PHYSICIAN ASSISTANT	2523	14	$23,912	$1,708	premium	14.0%	(608) 287-2050
11	PALM VALLEY MULTI-SPECIALTY MEDICAL GROUP PC	PALM DESERT	CA	PHYSICIAN ASSISTANT	16	13	$6,552	$504	premium	6.1%	(760) 760-4343
12	UNIVERSITY OF PENN - MEDICAL GROUP	PHILADELPHIA	PA	PHYSICIAN ASSISTANT	3505	11	$2,739	$249	premium	29.7%	(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 →