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

72255 Review by radiologist of middle spinal canal image CPT · CT Scan imaging

Classification Imaging › CT Scan › CT/CTA - Spine (CMS RBCS)

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

National scale 56 services ▼ 1.8% YoY · 54 beneficiaries (CY2024, Medicare FFS)

Medicare paid $5K · $85.00 avg / service, national

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.

Scaled from 14 observed FFS services.

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

+1.8%

All-Medicare est. · observed FFS -1.8%

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

Estimated all-Medicare volume estimate

FFS + estimated MA

~28 services

14 observed fee-for-service (50%) · ~14 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 — 72255 (CY2024)

NY 42 NV 14

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

Billed → allowed → paid

Named-group submitted charges

$5K

Named-group allowed amount

$1K

Named-group Medicare payments

$1K

Avg charge / svc

$366

Avg allowed / svc

$106

Avg payment / svc

$85

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

Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — the free tier previews every panel, gated.

Or just look at it: nuclear heart imaging (78452) in Arizona is open as a live example — the full paid view, real data.

View the live example →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 72255 services, highest first, CY2024
#	Physician group locked column	City locked column	St locked column	Specialty locked column	Providers locked column	72255 svcs	Submitted charges locked column	Avg charge locked column	Medicare $ locked column	Share of state* locked column	Phone
1	BERMAN AND PITMAN LTD	RENO	NV	NURSE PRACTITIONER	12	14	$5,124	$366	premium	100.0%	(775) 689-5410

*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 →