Medicare procedure market data by CPT code & state

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

63091 Removal of middle, lower, or sacral spine bone with release of spinal cord or nerves, transperitoneal or retroperitoneal approach, each additional segment 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 429 services · est. ▼ 39.1% YoY · 136 FFS beneficiaries (CY2024, all-Medicare estimate) — 214 observed fee-for-service services

Medicare paid $43K · est. · $100.28 avg / service, national — $21K observed FFS

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

Billing groups

Named groups billing this code

Named-group all-Medicare svcs · est.

289

Scaled from 144 observed FFS services.

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

-39.1%

All-Medicare est. · observed FFS -41.2%

Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.

Estimated all-Medicare volume estimate

FFS + estimated MA

~289 services

144 observed fee-for-service (50%) · ~145 estimated Medicare Advantage.

Billing for this code concentrates in one state — scaled by the national payer mix (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale

Top states — 63091 (CY2024)

CA 294 NV 140

Est. all-Medicare services by billing state (scaled estimate — assumes MA utilization mirrors FFS); open a bar for that state's ranked market.

Billed → allowed → paid

Named-group submitted charges

$262K

Named-group allowed amount

$20K

Named-group Medicare payments

$31K · est.

— $16K observed FFS

Avg charge / svc

$1,820

Avg allowed / svc

$137

Avg payment / svc

$109

Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.

Average charge per group

$214–776

$776–1,338

$1,338–1,900

$1,900–2,462

$2,462–3,024

$3,024–3,586

$3,586–4,148

$4,148+

$214 5 groups · avg submitted charge / service $5,509

Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — each panel renders gated on the free tier.

See it in full: nuclear heart imaging (78452) in Arizona is open as a live example — every paid panel, on real data.

View the live example →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 63091 services, highest first, CY2024
#	Physician group locked column	City locked column	St locked column	Specialty locked column	Providers locked column	63091 svcs	Submitted charges locked column	Avg charge locked column	Medicare $ locked column	Share of state* locked column	Phone
1	ORTHOPAEDIC SPECIALTY INSTITUTE MEDICAL GROUP OF ORANGE COUNTY	ORANGE	CA	PHYSICIAN ASSISTANT	58	52	$46,956	$903	premium	35.9%	(714) 634-4567
2	JAMES J LYNCH MD LTD	CARSON CITY	NV	PHYSICIAN ASSISTANT	84	31	$170,774	$5,509	premium	44.9%	(775) 783-6190
3	SPINE AND SPORTS SPECIALITIES MEDICAL GROUP	ORANGE	CA	ORTHOPEDIC SURGERY	15	26	$18,590	$715	premium	17.9%	(714) 598-1745
4	CITY OF HOPE MEDICAL FOUNDATION	DUARTE	CA	NURSE PRACTITIONER	942	21	$4,504	$214	premium	14.5%	(626) 256-4673
5	SCOTT LEARY MD INC	SAN DIEGO	CA	NEUROSURGERY	2	14	$21,200	$1,514	premium	9.7%	(858) 223-2100

*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 — and the observed foundation every market figure here builds on. Market totals anchor on a labeled all-Medicare estimate scaled from that foundation, with the observed count disclosed beside it — Medicare only, never all-payer. Modeled all-payer databases project every payer statistically and typically run higher. Same market, different denominator. How the numbers reconcile →