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

55873 Destruction of prostate using imaging guidance 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 497 services ▲ 36.9% YoY · 488 beneficiaries (CY2024, Medicare FFS)

Medicare paid $608K · $1223.06 avg / service, national

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

Billing groups

Named-group FFS services

307

FFS of Medicare

49%

Services YoY

+36.9%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~669 services

307 observed fee-for-service (46%) · ~362 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 — 55873 (CY2024)

FL 75 MN 64 NE 56 NY 53 CO 36

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

Named-group submitted charges

$4.1M

Named-group allowed amount

$292K

Named-group Medicare payments

$231K

Avg charge / svc

$13,286

Avg allowed / svc

$951

Avg payment / svc

$752

Average charge per group

$1,919–6,304

$6,304–10,689

$10,689–15,074

$15,074–19,459

$19,459–23,845

$23,845–28,230

$28,230–32,615

$32,615+

$1,919 14 groups · avg submitted charge / service $50,000

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.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 55873 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	55873 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	MAYO CLINIC	ROCHESTER	MN	NURSE PRACTITIONER	4896	64	$918,784	$14,356	premium	100.0%	(507) 284-2511
2	UNIVERSITY PHYSICIANS INCORPORATED	AURORA	CO	PHYSICIAN ASSISTANT	3122	36	$162,108	$4,503	premium	100.0%	(720) 777-1234
3	ORLANDO HEALTH MEDICAL GROUP INC	ORLANDO	FL	PHYSICIAN ASSISTANT	2145	32	$534,048	$16,689	premium	42.7%	(407) 896-1100
4	DUKE HEALTH INTEGRATED PRACTICE INC	DURHAM	NC	PHYSICIAN ASSISTANT	3051	27	$445,237	$16,490	premium	100.0%	(919) 684-8111
5	NORTHWESTERN MEDICAL FACULTY FOUNDATION	CHICAGO	IL	NURSE PRACTITIONER	4339	20	$86,100	$4,305	premium	60.6%	—
6	IU HEALTH MEDICAL GROUP, LLC	INDIANAPOLIS	IN	NURSE PRACTITIONER	4250	17	$69,000	$4,059	premium	100.0%	(888) 484-3258
7	THE REGENTS OF THE UNIVERSITY OF CALIFORNIA	LOS ANGELES	CA	UROLOGY	48	17	$850,000	$50,000	premium	60.7%	(310) 794-8492
8	UNION GENERAL AFFILIATED SERVICES, LLC	BLAIRSVILLE	GA	PHYSICIAN ASSISTANT	19	15	$28,785	$1,919	premium	51.7%	(706) 745-3333
9	NORTH SHORE-LIJ MEDICAL PC	MANHASSET	NY	PHYSICIAN ASSISTANT	6294	15	$86,685	$5,779	premium	28.3%	—
10	UNIVERSITY MEDICAL ASSOCIATES OF THE MEDICAL UNIVERSITY OF SOUTH CAROL	CHARLESTON	SC	PHYSICIAN ASSISTANT	1692	14	$62,965	$4,498	premium	100.0%	(843) 792-1414
11	MIDTOWN UROLOGY PC	ATLANTA	GA	UROLOGY	2	14	$76,000	$5,429	premium	48.3%	(404) 881-0966
12	DUPAGE MEDICAL GROUP LTD	GLEN ELLYN	IL	PHYSICIAN ASSISTANT	1323	13	$299,949	$23,073	premium	39.4%	(630) 469-9200
13	UROLOGY SPECIALIST GROUP LLC	HIALEAH	FL	UROLOGY	5	12	$360,000	$30,000	premium	16.0%	(305) 822-7227
14	MICHIGAN INSTITUTE OF UROLOGY PC	SAINT CLAIR SHORES	MI	UROLOGY	84	11	$99,000	$9,000	premium	100.0%	(586) 771-4820

*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 →