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

55840 Removal of prostate CPT · Other Organ Systems procedure

Classification Procedure › Other Organ Systems › Prostate Resection (CMS RBCS)

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

National scale 229 services ▼ 8.4% YoY · 229 beneficiaries (CY2024, Medicare FFS)

Medicare paid $130K · $568.60 avg / service, national

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

Billing groups

Named-group FFS services

146

FFS of Medicare

49%

Services YoY

-8.4%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~300 services

146 observed fee-for-service (49%) · ~154 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 — 55840 (CY2024)

MA 48 FL 37 CA 19 MN 18 WI 17

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

Named-group submitted charges

$746K

Named-group allowed amount

$112K

Named-group Medicare payments

$90K

Avg charge / svc

$5,109

Avg allowed / svc

$770

Avg payment / svc

$615

Average charge per group

$2,280–3,015

$3,015–3,750

$3,750–4,485

$4,485–5,220

$5,220–5,955

$5,955–6,690

$6,690–7,425

$7,425+

$2,280 10 groups · avg submitted charge / service $9,955

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.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 55840 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	55840 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	ALTHAUSEN MCGOVERN ASSOC INC	BOSTON	MA	NURSE PRACTITIONER	2	24	$132,000	$5,500	premium	50.0%	(617) 523-2394
2	MAYO CLINIC	ROCHESTER	MN	NURSE PRACTITIONER	4896	18	$107,394	$5,966	premium	100.0%	(507) 284-2511
3	MSKCC SURGERY GROUP	NEW YORK	NY	PHYSICIAN ASSISTANT	373	16	$159,280	$9,955	premium	100.0%	(212) 639-2000
4	MAYO CLINIC ARIZONA	PHOENIX	AZ	PHYSICIAN ASSISTANT	1635	14	$52,038	$3,717	premium	100.0%	(800) 603-0558
5	IU HEALTH MEDICAL GROUP, LLC	INDIANAPOLIS	IN	NURSE PRACTITIONER	4250	13	$58,211	$4,478	premium	100.0%	(888) 484-3258
6	PRISMA HEALTH UNIVERSITY MEDICAL GROUP	GREENVILLE	SC	NURSE PRACTITIONER	2447	13	$48,372	$3,721	premium	100.0%	—
7	H LEE MOFFITT CANCER CTR AND RES INST LIFE TIME CANCER SCRN CTR INC	TAMPA	FL	PHYSICIAN ASSISTANT	1103	13	$62,977	$4,844	premium	35.1%	(813) 745-4673
8	PRECISION HEALTHCARE SPECIALISTS, LLC	FORT MYERS	FL	PHYSICIAN ASSISTANT	100	12	$43,552	$3,629	premium	32.4%	(239) 291-6970
9	MOUNT SINAI MEDICAL CENTER UROLOGY LLC	MIAMI BEACH	FL	NURSE PRACTITIONER	25	12	$56,940	$4,745	premium	32.4%	(305) 674-2499
10	UROLOGY CLINICS OF NORTH TEXAS, PLLC	DALLAS	TX	UROLOGY	72	11	$25,080	$2,280	premium	100.0%	(214) 691-9377

*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 →