Medicare procedure market data by CPT code & state

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

63005 Partial removal of spine bone with exploration and/or release of lower spinal cord or nerves, 1-2 segments CPT · Musculoskeletal procedure

Classification Procedure › Musculoskeletal › Laminotomy or Laminectomy - Lumbar (CMS RBCS)

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

National scale 326 services ▼ 1.2% YoY · 323 beneficiaries (CY2024, Medicare FFS)

Medicare paid $219K · $672.31 avg / service, national

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

Billing groups

Named-group FFS services

158

FFS of Medicare

49%

Services YoY

-1.2%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~335 services

158 observed fee-for-service (47%) · ~177 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 — 63005 (CY2024)

WA 39 MN 33 AZ 31 TX 31 MD 30

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

Named-group submitted charges

$724K

Named-group allowed amount

$113K

Named-group Medicare payments

$90K

Avg charge / svc

$4,585

Avg allowed / svc

$712

Avg payment / svc

$567

Average charge per group

$911–1,941

$1,941–2,971

$2,971–4,001

$4,001–5,031

$5,031–6,061

$6,061–7,091

$7,091–8,121

$8,121+

$911 9 groups · avg submitted charge / service $9,844

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 63005 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	63005 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	33	$324,849	$9,844	premium	100.0%	(507) 284-2511
2	TUCSON PHYSICIAN GROUP HOLDINGS LLC	TUCSON	AZ	INTERNAL MEDICINE	200	31	$60,872	$1,964	premium	100.0%	(520) 396-1360
3	VIRGINIA SPINE INSTITUTE PLC	RESTON	VA	PHYSICIAN ASSISTANT	15	17	$15,486	$911	premium	100.0%	(703) 709-1114
4	ADVENTIST HEALTH SYSTEM GEORGIA INC	CALHOUN	GA	NURSE PRACTITIONER	229	15	$57,945	$3,863	premium	51.7%	—
5	HILLCREST PHYSICIAN SERVICES	WACO	TX	NURSE PRACTITIONER	113	15	$37,875	$2,525	premium	48.4%	(254) 202-7950
6	IHC HEALTH SERVICES INC	MURRAY	UT	PHYSICIAN ASSISTANT	3944	13	$39,767	$3,059	premium	100.0%	(801) 261-8346
7	MAYO CLINIC JACKSONVILLE	JACKSONVILLE	FL	NURSE PRACTITIONER	1587	12	$97,346	$8,112	premium	40.0%	(904) 953-2000
8	KADLEC REGIONAL MEDICAL CENTER	RICHLAND	WA	PHYSICIAN ASSISTANT	382	11	$28,226	$2,566	premium	28.2%	(509) 946-4611
9	USC CARE MEDICAL GROUP INC	LOS ANGELES	CA	DIAGNOSTIC RADIOLOGY	1374	11	$62,040	$5,640	premium	100.0%	(800) 872-2273

*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 →