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

52318 Crushing, fragmenting, and removal of bladder stones, more than 2.5 cm CPT · Other Organ Systems procedure

Classification Procedure › Other Organ Systems › Calculus Removal - Urinary (CMS RBCS)

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

National scale 633 services ▼ 11.3% YoY · 615 beneficiaries (CY2024, Medicare FFS)

Medicare paid $507K · $800.30 avg / service, national

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

Billing groups

Named-group FFS services

205

FFS of Medicare

49%

Services YoY

-11.3%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~413 services

205 observed fee-for-service (50%) · ~208 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 — 52318 (CY2024)

FL 90 CA 70 IL 57 NY 47 SC 39

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

Named-group submitted charges

$411K

Named-group allowed amount

$71K

Named-group Medicare payments

$56K

Avg charge / svc

$2,004

Avg allowed / svc

$346

Avg payment / svc

$271

Average charge per group

$1,253–1,461

$1,461–1,668

$1,668–1,876

$1,876–2,084

$2,084–2,292

$2,292–2,499

$2,499–2,707

$2,707+

$1,253 13 groups · avg submitted charge / service $3,221

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.

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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 52318 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	52318 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	36	$75,600	$2,100	premium	76.6%	(212) 241-4812
2	MUSC COMMUNITY PHYSICIANS	ORANGEBURG	SC	NURSE PRACTITIONER	1307	26	$83,740	$3,221	premium	66.7%	(803) 395-3400
3	SUTTER VALLEY MEDICAL FOUNDATION	SACRAMENTO	CA	DIAGNOSTIC RADIOLOGY	2420	18	$34,128	$1,896	premium	25.7%	(916) 681-8852
4	NORTHWESTERN MEDICAL FACULTY FOUNDATION	CHICAGO	IL	NURSE PRACTITIONER	4339	15	$38,130	$2,542	premium	26.3%	—
5	UROLOGY CARE OF CENTRAL FLORIDA, PA	OCALA	FL	PATHOLOGY	2	14	$17,542	$1,253	premium	15.6%	(352) 351-0029
6	FLORIDA CLINICAL PRACTICE ASSOCIATION INC	GAINESVILLE	MI	NURSE PRACTITIONER	1912	14	$37,953	$2,711	premium	51.9%	(352) 265-8990
7	PRISMA HEALTH UNIVERSITY MEDICAL GROUP	GREENVILLE	SC	NURSE PRACTITIONER	2447	13	$19,500	$1,500	premium	33.3%	—
8	FRANCISCAN MEDICAL GROUP	TACOMA	WA	PHYSICIAN ASSISTANT	1407	13	$17,449	$1,342	premium	100.0%	(253) 428-2200
9	PINEHURST SURGICAL CLINIC PA	PINEHURST	NC	PHYSICIAN ASSISTANT	91	12	$21,576	$1,798	premium	100.0%	(910) 295-6831
10	ISAAC MADEB MD PC	BROOKLYN	NY	UROLOGY	2	11	$16,500	$1,500	premium	23.4%	(718) 375-3746
11	UNIVERSITY PROFESSIONAL SERVICES	PORTLAND	OR	PHYSICIAN ASSISTANT	1717	11	$17,443	$1,586	premium	100.0%	(503) 494-8311
12	HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC	BOSTON	MA	INTERNAL MEDICINE	1689	11	$16,929	$1,539	premium	100.0%	(781) 983-9088
13	OXFORD UROLOGY ASSOCIATES PLLC	OXFORD	MS	UROLOGY	17	11	$14,337	$1,303	premium	36.7%	—

*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 →