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

68326 Reconstruction of conjunctiva with graft from outer eye or rearrangement CPT · Eye procedure

Classification Procedure › Eye (CMS RBCS)

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

National scale 1,551 services ▼ 24.1% YoY · 1,328 beneficiaries (CY2024, Medicare FFS)

Medicare paid $761K · $490.37 avg / service, national

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

Billing groups

Named-group FFS services

773

FFS of Medicare

49%

Services YoY

-24.1%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~1,484 services

773 observed fee-for-service (52%) · ~711 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 — 68326 (CY2024)

FL 295 TX 252 CA 244 MD 221 OH 144

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

Named-group submitted charges

$985K

Named-group allowed amount

$330K

Named-group Medicare payments

$262K

Avg charge / svc

$1,275

Avg allowed / svc

$427

Avg payment / svc

$339

Average charge per group

$800–955

$955–1,111

$1,111–1,266

$1,266–1,421

$1,421–1,577

$1,577–1,732

$1,732–1,887

$1,887+

$800 13 groups · avg submitted charge / service $2,306

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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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 68326 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	68326 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	SPACE COAST OPHTHALMOLOGY LLC	TITUSVILLE	FL	OPHTHALMOLOGY	4	191	$249,600	$1,307	premium	64.7%	(321) 267-0008
2	VENTURA EYE INSTITUTE, INC	CAMARILLO	CA	OPHTHALMOLOGY	2	177	$141,600	$800	premium	72.5%	(805) 388-1211
3	OPHTHALMIC PLASTIC AND ORBITAL CONSULTANTS PC	BETHESDA	MD	OPHTHALMOLOGY	2	170	$209,400	$1,232	premium	76.9%	(301) 571-0000
4	EYE PHYSICIANS, LLC	COLUMBUS	OH	OPHTHALMOLOGY	34	55	$76,545	$1,392	premium	38.2%	(614) 221-7464
5	OPHTHALMIC PLASTIC AND COSMETIC SURGERY INC	DES PERES	WA	PLASTIC AND RECONSTRUCTIVE SURGERY	4	30	$56,000	$1,867	premium	100.0%	(314) 567-3567
6	UNIVERSITY PHYSICIANS OF BROOKLYN, INC.	BROOKLYN	NY	OPHTHALMOLOGY	171	26	$59,956	$2,306	premium	24.8%	(718) 270-1714
7	UNMC PHYSICIANS	OMAHA	NE	PHYSICIAN ASSISTANT	1514	25	$45,560	$1,822	premium	100.0%	(402) 559-4000
8	CHESAPEAKE EYE CARE AND LASER CENTER LLC	ANNAPOLIS	MD	OPHTHALMOLOGY	78	25	$37,400	$1,496	premium	11.3%	(410) 571-8733
9	AZUL COSMETIC SURGERY AND MEDICAL SPA PA	FORT MYERS	FL	OPHTHALMOLOGY	3	18	$30,000	$1,667	premium	6.1%	(239) 415-7576
10	JERVEY EYE GROUP PA	GREENVILLE	SC	OPHTHALMOLOGY	20	16	$22,721	$1,420	premium	100.0%	(864) 458-7956
11	OCULOPLASTIC ASSOCIATES OF TEXAS PLLC	DALLAS	TX	OPHTHALMOLOGY	4	15	$17,332	$1,155	premium	6.0%	(214) 369-0555
12	THOMAS EYE GROUP PC	ROSWELL	GA	OPTOMETRY	56	13	$19,647	$1,511	premium	32.5%	(770) 475-5515
13	MILAN EYE LLC	JOHNS CREEK	GA	OPHTHALMOLOGY	20	12	$19,541	$1,628	premium	30.0%	(678) 381-2020

*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 →