Medicare procedure market data by CPT code & state

+ Build a code basket

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

57285 Repair of vaginal wall defect through vagina 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 444 services ▼ 4.1% YoY · 444 beneficiaries (CY2024, Medicare FFS)

Medicare paid $124K · $279.68 avg / service, national

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

Billing groups

Named-group FFS services

317

FFS of Medicare

49%

Services YoY

-4.1%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~666 services

317 observed fee-for-service (48%) · ~349 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 — 57285 (CY2024)

FL 128 OH 54 SC 53 AL 43 DE 40

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

Named-group submitted charges

$562K

Named-group allowed amount

$110K

Named-group Medicare payments

$87K

Avg charge / svc

$1,773

Avg allowed / svc

$346

Avg payment / svc

$274

Average charge per group

$1,145–1,302

$1,302–1,459

$1,459–1,615

$1,615–1,772

$1,772–1,929

$1,929–2,086

$2,086–2,243

$2,243+

$1,145 10 groups · avg submitted charge / service $2,457

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.

Notify me at launch →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 57285 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	57285 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	FLORIDA HOSPITAL HEALTHCARE PARTNERS, INC	DAYTONA BEACH	FL	PHYSICIAN ASSISTANT	588	53	$113,844	$2,148	premium	41.4%	(386) 231-6000
2	GEORGETOWN PHYSICIAN ASSOCIATES, LLC	MURRELLS INLET	SC	FAMILY PRACTICE	230	53	$61,798	$1,166	premium	100.0%	(843) 652-8450
3	INSTITUTE FOR WOMEN'S HEALTH AND BODY LLC	WEST PALM BEACH	FL	OBSTETRICS/GYNECOLOGY	49	40	$98,272	$2,457	premium	31.2%	(561) 616-9988
4	SAINT LUKES PHYSICIAN GROUP INC	KANSAS CITY	MO	NURSE PRACTITIONER	1228	30	$52,050	$1,735	premium	100.0%	—
5	CHRISTIANA CARE HEALTH SERVICES INC	NEWARK	DE	PHYSICIAN ASSISTANT	1537	28	$52,478	$1,874	premium	70.0%	—
6	MERCY HEALTH PHYSICIANS CINCINNATI SPECIALTY CARE LLC	CINCINNATI	OH	NURSE PRACTITIONER	347	28	$32,060	$1,145	premium	51.9%	(513) 751-4222
7	CHRIST HOSPITAL MEDICAL SPECIALISTS LLC	CINCINNATI	OH	OBSTETRICS/GYNECOLOGY	129	26	$36,376	$1,399	premium	48.1%	(513) 241-4774
8	HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC	NEPTUNE	PA	NURSE PRACTITIONER	1878	19	$42,910	$2,258	premium	100.0%	(732) 362-3663
9	ADVANCED UROGYNECOLOGY OF MICHIGAN PC	DEARBORN	MI	OBSTETRICS/GYNECOLOGY	2	16	$20,544	$1,284	premium	100.0%	(313) 982-0200
10	VITALMD GROUP HOLDING LLC	MIAMI	FL	OBSTETRICS/GYNECOLOGY	531	13	$24,835	$1,910	premium	10.2%	(305) 273-4641
11	HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC	NEPTUNE	NJ	NURSE PRACTITIONER	1878	11	$26,984	$2,453	premium	100.0%	(732) 362-3663

*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 →