Medicare procedure market data by CPT code & state

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Market snapshot

IL 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 · National figures — the IL market is below

Market analyticsPlatform Methods →

The full market analysis for this code & state — the shapes are yours; the numbers unlock with Platform.

The read

What am I looking at, in one breath?

The read Platform

In Illinois, 1 group bills 51999 — 41 fee-for-service services, and volume is up 32.5% year over year.

The orienting line is free; the comparative synthesis — growth rank, concentration, and $/service against the national figure — unlocks with Platform.

The snapshot

The honest, real numbers — free, always.

Billing groups

Named groups billing this code in IL

Named-group FFS services

Attributable volume · fee-for-service

FFS of Medicare

57%

Payer-mix frame

Named-group coverage

57%

Of Illinois’s disclosed Part B services (2024). The rest is billed by clinicians whose volume isn’t attributed to any group — they belong to several groups, or none. How attribution works →

Services · year over year

Services YoY

+32.5%

FFS enrollment -2.7%

Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.

Estimated all-Medicare volume estimate

FFS + estimated MA

~72 services

41 observed fee-for-service (57%) · ~31 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

The market

How big, moving which way, worth how much.

Billed → allowed → paid

Named-group submitted charges

$306K

Named-group allowed amount

$76K

Named-group Medicare payments

$60K

Avg charge / svc

$7,458

Avg allowed / svc

$1,847

Avg payment / svc

$1,475

Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.

Per-service vs national + the payments trend unlock with Platform

12-year trend

The full twelve-year services and payments series, per-year values.

The structure

Who's in this market and how it's shaped.

Market structure

Concentration is not shown for markets under 11 billing groups.

Market position

Where this market sits on volume and growth among all state markets, and its rank.

National benchmarks

Where each group's volume sits nationally and within its specialty.

The opportunity

So where do I act?

Worth a look

Every state market for this search, ranked by a published score: size, growth, fragmentation, below-expected volume. The cross-market compare view sits alongside.

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 →

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	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	NORTHWESTERN MEDICAL FACULTY FOUNDATION	CHICAGO	NURSE PRACTITIONER	4339	41	$305,791	$7,458	premium	77.4%	—

*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 →