Medicare procedure market data by CPT code & state

+ Build a code basket

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

51999 Other procedure on bladder using an endoscope CPT · Other Organ Systems procedure

Classification Procedure › Other Organ Systems (CMS RBCS)

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

National scale 524 services ▲ 12.9% YoY · 518 beneficiaries (CY2024, Medicare FFS)

Medicare paid $754K · $1439.34 avg / service, national

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

Billing groups

Named-group FFS services

364

FFS of Medicare

49%

Services YoY

+12.9%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~711 services

364 observed fee-for-service (51%) · ~347 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 — 51999 (CY2024)

NY 104 TX 61 CO 61 IL 53 MD 48

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

Named-group submitted charges

$4.6M

Named-group allowed amount

$626K

Named-group Medicare payments

$500K

Avg charge / svc

$12,742

Avg allowed / svc

$1,720

Avg payment / svc

$1,373

Average charge per group

$5,236–8,234

$8,234–11,232

$11,232–14,230

$14,230–17,228

$17,228–20,226

$20,226–23,223

$23,223–26,221

$26,221+

$5,236 17 groups · avg submitted charge / service $30,000

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.

Notify me at launch →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 51999 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	51999 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	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	NEW YORK	NY	PHYSICIAN ASSISTANT	2818	49	$1,470,000	$30,000	premium	47.1%	(212) 241-4812
2	JOHNS HOPKINS UNIVERSITY	BALTIMORE	MD	NURSE PRACTITIONER	2900	48	$335,087	$6,981	premium	100.0%	(410) 502-4340
3	NORTHWESTERN MEDICAL FACULTY FOUNDATION	CHICAGO	IL	NURSE PRACTITIONER	4339	41	$305,791	$7,458	premium	77.4%	—
4	UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS	DALLAS	TX	PHYSICIAN ASSISTANT	3200	33	$298,300	$9,039	premium	54.1%	(214) 633-5555
5	MAYO CLINIC JACKSONVILLE	JACKSONVILLE	FL	NURSE PRACTITIONER	1587	25	$571,759	$22,870	premium	65.8%	(904) 953-2000
6	NEW YORK UNIVERSITY	NEW YORK	NY	DIAGNOSTIC RADIOLOGY	5704	24	$364,100	$15,171	premium	23.1%	(212) 263-9700
7	PHYSICIANS REFERRAL SERVICE	HOUSTON	TX	NURSE PRACTITIONER	2696	15	$435,359	$29,024	premium	24.6%	(713) 592-5433
8	OU HEALTH PARTNERS INC	OKLAHOMA CITY	OK	PHYSICIAN ASSISTANT	1160	15	$92,113	$6,141	premium	100.0%	(405) 271-4311
9	CITY OF HOPE MEDICAL FOUNDATION	DUARTE	CA	NURSE PRACTITIONER	942	14	$75,041	$5,360	premium	35.0%	(626) 256-4673
10	THE REGENTS OF THE UNIVERSITY OF CALIFORNIA	LOS ANGELES	CA	UROLOGY	48	14	$104,540	$7,467	premium	35.0%	(310) 794-8492
11	UNIVERSITY OF LOUISVILLE PHYSICIANS INC	LOUISVILLE	KY	NURSE PRACTITIONER	1442	13	$68,070	$5,236	premium	100.0%	(502) 629-2398
12	FLORIDA HOSPITAL MEDICAL GROUP INC	MAITLAND	FL	PHYSICIAN ASSISTANT	1634	13	$71,383	$5,491	premium	34.2%	(407) 200-2700
13	THE ASSOCIATION OF UNIVERSITY PHYSICIANS	SEATTLE	WA	PHYSICIAN ASSISTANT	3612	13	$69,630	$5,356	premium	100.0%	(206) 364-0500
14	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO	SAN ANTONIO	TX	PHYSICIAN ASSISTANT	1326	13	$97,051	$7,465	premium	21.3%	(210) 450-7044
15	USC CARE MEDICAL GROUP INC	LOS ANGELES	CA	DIAGNOSTIC RADIOLOGY	1374	12	$101,700	$8,475	premium	30.0%	(800) 872-2273
16	WASHINGTON UNIVERSITY	SAINT LOUIS	MO	NURSE PRACTITIONER	3070	11	$98,430	$8,948	premium	100.0%	(314) 747-3000
17	VANDERBILT UNIVERSITY MEDICAL CENTER	NASHVILLE	TN	NURSE PRACTITIONER	3394	11	$79,871	$7,261	premium	100.0%	(615) 322-5000

*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 →