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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
49592 Initial repair of entrapped hernia of abdomen, less than 3 cm in length CPT · Procedure
Classification Procedure Digestive/Gastrointestinal (CMS RBCS)
First observed 2023
National scale 673 services ▲ 17.0% YoY · 672 beneficiaries (CY2024, Medicare FFS)
Medicare paid $367K · $545.24 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
20
Named-group FFS services
360
FFS of Medicare
49%
Services YoY
+17.0%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~699 services

360 observed fee-for-service (52%) · ~339 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 — 49592 (CY2024)

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

Named-group submitted charges
$485K
Named-group allowed amount
$135K
Named-group Medicare payments
$107K
Avg charge / svc
$1,348
Avg allowed / svc
$376
Avg payment / svc
$296
Average charge per group
$684 20 groups · avg submitted charge / service $2,704
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 49592 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 49592 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 PIEDMONT PROVIDERS LLC ATLANTA GA PHYSICIAN ASSISTANT 509 42 $49,770 $1,185 premium 100.0% (404) 367-3210
2 ARIZONA ADVANCED SURGERY LLC PHOENIX AZ GENERAL SURGERY 89 32 $35,341 $1,104 premium 25.0% (602) 340-0201
3 BEEBE PHYSICIAN NETWORK INC. LEWES DE PHYSICIAN ASSISTANT 295 28 $27,492 $982 premium 100.0% (302) 645-3525
4 TUCSON PHYSICIAN GROUP HOLDINGS LLC TUCSON AZ INTERNAL MEDICINE 200 28 $33,684 $1,203 premium 21.9% (520) 396-1360
5 CHS PHYSICIAN PARTNERS PC ROSLYN NY PHYSICIAN ASSISTANT 734 23 $39,468 $1,716 premium 60.5%
6 EISENHOWER MEDICAL CENTER RANCHO MIRAGE CA NURSE PRACTITIONER 457 19 $22,781 $1,199 premium 31.1% (760) 340-3911
7 NORTHWESTERN MEDICAL FACULTY FOUNDATION CHICAGO IL NURSE PRACTITIONER 4339 19 $51,376 $2,704 premium 36.5%
8 KADLEC REGIONAL MEDICAL CENTER RICHLAND WA PHYSICIAN ASSISTANT 382 18 $28,440 $1,580 premium 100.0% (509) 946-4611
9 COTTAGE MEDICAL FOUNDATION GOLETA CA INTERNAL MEDICINE 74 18 $33,838 $1,880 premium 29.5% (805) 879-4240
10 WASHINGTON REGIONAL MEDICAL SYSTEM FAYETTEVILLE AR NURSE PRACTITIONER 241 15 $15,525 $1,035 premium 100.0% (479) 571-4338
11 ST PAUL PLACE SPECIALISTS, INC. BALTIMORE MD PHYSICIAN ASSISTANT 337 15 $23,430 $1,562 premium 11.3% (410) 663-8100
12 SMH PHYSICIAN SERVICES INC SARASOTA FL PHYSICIAN ASSISTANT 766 13 $13,975 $1,075 premium 32.5%
13 TENET FLORIDA PHYSICIAN SERVICES LLC DELRAY BEACH FL CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 224 13 $14,629 $1,125 premium 32.5% (561) 498-4440
14 SSM MEDICAL GROUP INC SAINT LOUIS MO NURSE PRACTITIONER 547 11 $12,210 $1,110 premium 50.0% (314) 645-6450
15 PRIVIA MEDICAL GROUP, LLC ARLINGTON MD NURSE PRACTITIONER 1477 11 $23,375 $2,125 premium 8.3%
16 TEXAS HEALTH PHYSICIANS GROUP FORT WORTH TX PHYSICIAN ASSISTANT 1350 11 $7,524 $684 premium 47.8% (817) 281-2977
17 ENDEAVOR HEALTH MEDICAL GROUP EVANSTON IL NURSE PRACTITIONER 3380 11 $13,101 $1,191 premium 21.2%
18 MAIN LINE HEALTHCARE BRYN MAWR PA NURSE PRACTITIONER 1157 11 $12,595 $1,145 premium 100.0%
19 MERCY CLINIC SURGICAL SPECIALISTS LLC SAINT LOUIS MO PHYSICIAN ASSISTANT 177 11 $12,672 $1,152 premium 50.0% (314) 567-5850
20 ADVANCED SURGICAL CARE OF NORTHERN ILLINOIS, LTD BARRINGTON IL GENERAL SURGERY 9 11 $14,140 $1,285 premium 21.2% (847) 381-8161

*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 →