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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
53899 Other procedure on urinary system 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 443 services ▲ 20.1% YoY · 436 beneficiaries (CY2024, Medicare FFS)
Medicare paid $97K · $219.94 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
8
Named-group FFS services
398
FFS of Medicare
49%
Services YoY
+20.1%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~769 services

398 observed fee-for-service (52%) · ~371 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 — 53899 (CY2024)

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

Named-group submitted charges
$792K
Named-group allowed amount
$111K
Named-group Medicare payments
$89K
Avg charge / svc
$1,989
Avg allowed / svc
$279
Avg payment / svc
$222
Average charge per group
$53 8 groups · avg submitted charge / service $8,571
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 53899 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 53899 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 AUC UROLOGISTS LLC MYRTLE BEACH SC PHYSICIAN ASSISTANT 28 206 $160,680 $780 premium 84.4% (843) 347-2450
2 MAYO CLINIC ROCHESTER MN NURSE PRACTITIONER 4896 47 $402,820 $8,571 premium 100.0% (507) 284-2511
3 EL CAMINO HEALTH MEDICAL NETWORK LLC SAN JOSE CA PHYSICIAN ASSISTANT 199 39 $2,084 $53 premium 100.0% (408) 871-3400
4 GEORGETOWN PHYSICIAN ASSOCIATES, LLC MURRELLS INLET SC FAMILY PRACTICE 230 38 $29,640 $780 premium 15.6% (843) 652-8450
5 SUMMIT MEDICAL GROUP PA BERKELEY HEIGHTS NJ PHYSICIAN ASSISTANT 1183 20 $41,780 $2,089 premium 100.0% (908) 273-4300
6 VIRGINIA HOSPITAL CENTER PHYSICIAN GROUP LLC ARLINGTON VA NURSE PRACTITIONER 345 18 $113,681 $6,316 premium 100.0%
7 ADVANCED UROLOGY PLLC EVERGREEN CO UROLOGY 61 15 $27,975 $1,865 premium 100.0% (303) 985-2550
8 FLORIDA HOSPITAL MEDICAL GROUP INC MAITLAND FL PHYSICIAN ASSISTANT 1634 15 $13,020 $868 premium 100.0% (407) 200-2700

*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 →