Medicare procedure market data by CPT code & state

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

63035 Partial removal of spine bone with release of upper or lower spinal cord or nerves and/or removal of disc, each additional interspace 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 958 services ▼ 19.7% YoY · 607 beneficiaries (CY2024, Medicare FFS)

Medicare paid $153K · $159.28 avg / service, national

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

Billing groups

Named-group FFS services

786

FFS of Medicare

49%

Services YoY

-19.7%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~1,523 services

786 observed fee-for-service (52%) · ~737 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 — 63035 (CY2024)

CA 381 IL 177 AZ 157 MD 97 WA 51

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

Named-group submitted charges

$1.3M

Named-group allowed amount

$151K

Named-group Medicare payments

$120K

Avg charge / svc

$1,598

Avg allowed / svc

$192

Avg payment / svc

$153

Average charge per group

$294–651

$651–1,008

$1,008–1,365

$1,365–1,722

$1,722–2,080

$2,080–2,437

$2,437–2,794

$2,794+

$294 13 groups · avg submitted charge / service $3,753

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 63035 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	63035 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	DESERT INSTITUTE FOR SPINE CARE PC	PHOENIX	AZ	PHYSICIAN ASSISTANT	12	157	$224,981	$1,433	premium	100.0%	(602) 944-2900
2	ORTHOPAEDIC CENTER OF IL	SPRINGFIELD	IL	ORTHOPEDIC SURGERY	30	150	$562,890	$3,753	premium	84.7%	(217) 547-9100
3	SCRIPPS HEALTH	LA JOLLA	CA	PHYSICIAN ASSISTANT	1431	117	$199,957	$1,709	premium	30.7%	(858) 455-9100
4	MONTEREY SPINE AND JOINT PC	MONTEREY	CA	PHYSICAL THERAPIST IN PRIVATE PRACTICE	80	69	$46,505	$674	premium	18.1%	(831) 648-7200
5	CHRISTOPHER O NEUBUERGER MD INC	SACRAMENTO	CA	ORTHOPEDIC SURGERY	2	46	$44,297	$963	premium	12.1%	(916) 229-8890
6	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	MD	INTERNAL MEDICINE	3716	41	$40,152	$979	premium	42.3%	(415) 600-1020
7	THE ASSOCIATION OF UNIVERSITY PHYSICIANS	SEATTLE	WA	PHYSICIAN ASSISTANT	3612	33	$24,214	$734	premium	64.7%	(206) 364-0500
8	VIVEK A MEHTA MD INC	IRVINE	CA	CLINICAL PSYCHOLOGIST	7	32	$9,400	$294	premium	8.4%	(949) 344-3468
9	THE ASSOCIATION OF UNIVERSITY PHYSICIANS	SEATTLE	TX	PHYSICIAN ASSISTANT	3612	27	$19,600	$726	premium	58.7%	(206) 364-0500
10	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	CA	INTERNAL MEDICINE	3716	24	$4,099	$171	premium	6.3%	(415) 600-1020
11	USC CARE MEDICAL GROUP INC	LOS ANGELES	CA	DIAGNOSTIC RADIOLOGY	1374	22	$8,646	$393	premium	5.8%	(800) 872-2273
12	YOSHIHIRO KATSUURA PROFESSIONAL CORPORATION	NOVATO	CA	ORTHOPEDIC SURGERY	2	20	$15,000	$750	premium	5.2%	(415) 697-8659
13	THOMAS S LOFTUS MD PA	AUSTIN	TX	NEUROSURGERY	3	19	$17,803	$937	premium	41.3%	(512) 836-0900
14	EXCEL SPINE AND ORTHOPEDIC INSTITUTE LLC	HONOLULU	WA	NURSE PRACTITIONER	9	18	$8,334	$463	premium	35.3%	(808) 358-6200
15	JEFFERSON UNIVERSITY PHYSICIANS	PHILADELPHIA	PA	DIAGNOSTIC RADIOLOGY	1570	11	$30,250	$2,750	premium	100.0%	—

*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 →