Medicare procedure market data by CPT code & state

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

66989 Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye CPT · Eye procedure

Classification Procedure › Eye › Cataract Surgery (CMS RBCS)

First observed 2022

National scale 3,501 services · est. ▲ 20.3% YoY · 1,312 FFS beneficiaries (CY2024, all-Medicare estimate) — 1,795 observed fee-for-service services

Medicare paid $6.9M · est. · $1955.92 avg / service, national — $3.5M 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.

1,400

Scaled from 704 observed FFS services.

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

+20.3%

All-Medicare est. · observed FFS +15.6%

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

Estimated all-Medicare volume estimate

FFS + estimated MA

~1,400 services

704 observed fee-for-service (50%) · ~696 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 — 66989 (CY2024)

CA 1,670 NY 247 NJ 184 NC 177 AL 163

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

$2.0M

Named-group allowed amount

$560K

Named-group Medicare payments

$885K · est.

— $444K observed FFS

Avg charge / svc

$2,864

Avg allowed / svc

$795

Avg payment / svc

$630

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

$1,254–2,005

$2,005–2,757

$2,757–3,508

$3,508–4,259

$4,259–5,010

$5,010–5,762

$5,762–6,513

$6,513+

$1,254 22 groups · avg submitted charge / service $7,400

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 66989 services, highest first, CY2024
#	Physician group locked column	City locked column	St locked column	Specialty locked column	Providers locked column	66989 svcs	Submitted charges locked column	Avg charge locked column	Medicare $ locked column	Share of state* locked column	Phone
1	RIDGE EYE CARE INC	MARYSVILLE	CA	OPTOMETRY	19	213	$291,597	$1,369	premium	25.9%	(530) 743-1873
2	SINGLETON VISION CENTER	NEW BERN	NC	OPHTHALMOLOGY	2	64	$230,400	$3,600	premium	81.0%	(252) 514-2155
3	KANSAL EYE PHYSICIANS AND SURGEONS CHARTERED	SALINA	KS	OPHTHALMOLOGY	2	54	$397,002	$7,352	premium	50.9%	(785) 825-2003
4	HARRUP KAUR MD INC	SAN JOSE	CA	OPTOMETRY	6	38	$78,432	$2,064	premium	4.6%	(408) 940-3930
5	EYE PARTNERS PC	DOTHAN	AL	OPTOMETRY	31	25	$82,500	$3,300	premium	37.9%	(334) 793-2211

That's the top 5 of 22 groups. The platform ranks the whole market — code baskets, benchmarks, and the full ranked list. the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

*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 →