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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
49507 Repair of trapped groin hernia (5 years or older) CPT · Procedure
Classification Procedure Digestive/Gastrointestinal Hernia Repair - Open (inguinal) (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 1,027 services ▼ 7.6% YoY · 1,018 beneficiaries (CY2024, Medicare FFS)
Medicare paid $597K · $581.59 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
25
Named-group FFS services
551
FFS of Medicare
49%
Services YoY
-7.6%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~1,058 services

551 observed fee-for-service (52%) · ~507 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 — 49507 (CY2024)

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

Named-group submitted charges
$1.5M
Named-group allowed amount
$315K
Named-group Medicare payments
$248K
Avg charge / svc
$2,650
Avg allowed / svc
$572
Avg payment / svc
$449
Average charge per group
$1,101 25 groups · avg submitted charge / service $8,500
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 49507 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 49507 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 SUMMIT MEDICAL GROUP PA BERKELEY HEIGHTS NJ PHYSICIAN ASSISTANT 1183 88 $298,390 $3,391 premium 39.6% (908) 273-4300
2 COMMUNITY HEALTH PARTNERS FRESNO CA INTERNAL MEDICINE 509 43 $74,047 $1,722 premium 20.1% (559) 459-6000
3 MAIMONIDES FACULTY PRACTICE PLAN BROOKLYN NY PHYSICIAN ASSISTANT 243 32 $272,000 $8,500 premium 18.1% (718) 283-6000
4 COVENANT MEDICAL GROUP INC KNOXVILLE TN NURSE PRACTITIONER 333 29 $47,850 $1,650 premium 100.0% (865) 632-5885
5 SOUTH ORANGE COUNTY SURGICAL MEDICAL GROUP INC LAGUNA HILLS CA GENERAL SURGERY 22 28 $30,816 $1,101 premium 13.1% (949) 457-7900
6 NORTH SHORE-LIJ MEDICAL PC MANHASSET NY PHYSICIAN ASSISTANT 6294 27 $80,082 $2,966 premium 15.3%
7 PROVIDENCE HEALTH AND SERVICES WASHINGTON SPOKANE WA PHYSICIAN ASSISTANT 771 24 $45,218 $1,884 premium 40.0%
8 SINAI HOSPITAL OF BALTIMORE, INC BALTIMORE MD PHYSICIAN ASSISTANT 386 22 $40,704 $1,850 premium 27.8%
9 MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC HOLLYWOOD MD INTERNAL MEDICINE 236 21 $33,390 $1,590 premium 26.6%
10 WHITE PLAINS PHYSICIAN SERVICES PC WHITE PLAINS NY PHYSICIAN ASSISTANT 383 20 $58,355 $2,918 premium 11.3% (914) 681-0600
11 WATSON CLINIC LLP LAKELAND FL NURSE PRACTITIONER 363 20 $31,200 $1,560 premium 15.2% (863) 680-7780
12 CASCADE HERNIA AND SURGICAL SOLUTIONS PS PUYALLUP WA GENERAL SURGERY 3 19 $39,653 $2,087 premium 31.7% (253) 840-1999
13 LEXINGTON HEALTH INC WEST COLUMBIA SC NURSE PRACTITIONER 909 18 $37,989 $2,110 premium 100.0% (803) 744-4900
14 RUSH UNIVERSITY MEDICAL GROUP CHICAGO IL PHYSICIAN ASSISTANT 1496 16 $33,232 $2,077 premium 51.6% (312) 563-2875
15 GOLDEN VALLEY HEALTH CENTERS MODESTO CA FAMILY PRACTICE 115 14 $42,000 $3,000 premium 6.5% (209) 722-4842
16 EISENHOWER MEDICAL CENTER RANCHO MIRAGE CA NURSE PRACTITIONER 457 13 $19,760 $1,520 premium 6.1% (760) 340-3911
17 SURGICAL MULTISPECIALTIES MEDICAL GROUP LOS ANGELES CA GENERAL SURGERY 5 12 $22,440 $1,870 premium 5.6% (323) 264-2633
18 COLUMBIA HEALTHCARE OF CENTRAL VIRGINIA INC NORTH CHESTERFIELD VA PHYSICIAN ASSISTANT 30 12 $25,000 $2,083 premium 100.0% (804) 716-5520
19 SCRIPPS HEALTH LA JOLLA CA PHYSICIAN ASSISTANT 1431 12 $26,265 $2,189 premium 5.6% (858) 455-9100
20 WEILL MEDICAL COLLEGE OF CORNELL NEW YORK NY INTERNAL MEDICINE 2053 12 $74,100 $6,175 premium 6.8% (212) 746-5454
21 MERITAS HEALTH CORPORATION NORTH KANSAS CITY MO NEUROLOGY 498 12 $19,914 $1,660 premium 100.0% (816) 472-5157
22 SOUTH TEXAS PHYSICIAN GROUP PLLC FREDERICKSBURG TX NURSE PRACTITIONER 16 12 $20,604 $1,717 premium 100.0% (830) 990-1404
23 IQ SURGICAL ASSOCIATES INC VISALIA CA GENERAL SURGERY 5 12 $15,275 $1,273 premium 5.6% (559) 302-5600
24 SUMMIT MEDICAL GROUP PA BERKELEY HEIGHTS NY PHYSICIAN ASSISTANT 1183 11 $36,674 $3,334 premium 6.2% (908) 273-4300
25 YASSER SALEM MD PROFESSIONAL CORP HUNTINGTON BEACH CA PHYSICIAN ASSISTANT 3 11 $17,358 $1,578 premium 5.1% (714) 545-5200
26 SMH PHYSICIAN SERVICES INC SARASOTA FL PHYSICIAN ASSISTANT 766 11 $17,930 $1,630 premium 8.3%

*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 →