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

63057 Release of middle or lower spinal cord and/or nerves, single segment CPT · Musculoskeletal procedure

Classification Procedure › Musculoskeletal (CMS RBCS)

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

National scale 1,347 services ▼ 8.6% YoY · 804 beneficiaries (CY2024, Medicare FFS)

Medicare paid $217K · $161.35 avg / service, national

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

Billing groups

Named-group FFS services

620

FFS of Medicare

49%

Services YoY

-8.6%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~1,286 services

620 observed fee-for-service (48%) · ~666 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 — 63057 (CY2024)

CA 735 MN 149 NV 141 DC 123 FL 108

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

Named-group submitted charges

$474K

Named-group allowed amount

$91K

Named-group Medicare payments

$73K

Avg charge / svc

$765

Avg allowed / svc

$147

Avg payment / svc

$118

Average charge per group

$96–452

$452–808

$808–1,165

$1,165–1,521

$1,521–1,877

$1,877–2,233

$2,233–2,590

$2,590+

$96 14 groups · avg submitted charge / service $3,100

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 63057 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	63057 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	COMMUNITY FOUNDATION MEDICAL GROUP	FRESNO	CA	PHYSICIAN ASSISTANT	292	150	$44,600	$297	premium	20.4%	—
2	JAMES J LYNCH MD LTD	CARSON CITY	NV	PHYSICIAN ASSISTANT	84	81	$97,556	$1,204	premium	57.4%	(775) 783-6190
3	ORTHOPAEDIC SPECIALTY INSTITUTE MEDICAL GROUP OF ORANGE COUNTY	ORANGE	CA	PHYSICIAN ASSISTANT	58	64	$22,776	$356	premium	8.7%	(714) 634-4567
4	LYERLY BAPTIST INC	JACKSONVILLE	FL	NURSE PRACTITIONER	68	61	$30,179	$495	premium	56.5%	(904) 388-6518
5	FARHAN SIDDIQI MD PA	BROOKSVILLE	FL	ORTHOPEDIC SURGERY	16	47	$134,550	$2,863	premium	43.5%	(352) 597-0907
6	HUTCHINSON REGIONAL MEDICAL CENTER INC	HUTCHINSON	KS	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)	149	33	$4,125	$125	premium	100.0%	(620) 665-2000
7	FARZAD MASSOUDI MD INCORPORATED	LAGUNA HILLS	CA	NEUROSURGERY	2	30	$18,000	$600	premium	4.1%	(949) 588-5800
8	RIVERVIEW HEALTHCARE ASSOCIATION	CROOKSTON	MN	NURSE PRACTITIONER	44	27	$7,117	$264	premium	18.1%	(218) 281-9200
9	ATRIUM HEALTH NEUROSPINE NETWORK LLC	CHARLOTTE	CA	PHYSICIAN ASSISTANT	98	27	$2,592	$96	premium	3.7%	(704) 376-1605
10	REJUV MEDICAL PA	WAITE PARK	MN	NURSE PRACTITIONER	16	23	$6,536	$284	premium	15.4%	(320) 217-8480
11	FORT WORTH BRAIN AND SPINE INSTITUTE, LLP	FORT WORTH	TX	NEUROSURGERY	11	22	$15,400	$700	premium	100.0%	(817) 878-5333
12	GRAND STRAND SPECIALTY ASSOCIATES, LLC	MYRTLE BEACH	SC	PHYSICIAN ASSISTANT	32	21	$19,600	$933	premium	100.0%	(843) 692-1000
13	ERIK C SPAYDE MD INC	THOUSAND OAKS	CA	PHYSICIAN ASSISTANT	4	19	$58,900	$3,100	premium	2.6%	8053792322119
14	EXCEL SPINE AND ORTHOPEDIC INSTITUTE LLC	HONOLULU	WA	NURSE PRACTITIONER	9	15	$12,238	$816	premium	100.0%	(808) 358-6200

*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 →