Medicare procedure market data by CPT code & state

+ Build a code basket

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

74485 Review by radiologist of ureter or urethra image CPT · Standard X-ray imaging

Classification Imaging › Standard X-ray (CMS RBCS)

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

National scale 625 services ▼ 16.6% YoY · 522 beneficiaries (CY2024, Medicare FFS)

Medicare paid $23K · $36.33 avg / service, national

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

Billing groups

Named-group FFS services

440

FFS of Medicare

49%

Services YoY

-16.6%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~855 services

440 observed fee-for-service (51%) · ~415 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 — 74485 (CY2024)

CA 140 NY 139 TX 113 MA 64 HI 43

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

Named-group submitted charges

$456K

Named-group allowed amount

$21K

Named-group Medicare payments

$17K

Avg charge / svc

$1,036

Avg allowed / svc

$49

Avg payment / svc

$39

Average charge per group

$76–359

$359–643

$643–926

$926–1,209

$1,209–1,492

$1,492–1,776

$1,776–2,059

$2,059+

$76 10 groups · avg submitted charge / service $3,703

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.

View the live example →

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.

Notify me at launch →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 74485 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	74485 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	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	NEW YORK	NY	PHYSICIAN ASSISTANT	2818	108	$399,951	$3,703	premium	77.7%	(212) 241-4812
2	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	CA	INTERNAL MEDICINE	3716	72	$11,736	$163	premium	51.4%	(415) 600-1020
3	MONTAGE MEDICAL GROUP	MONTEREY	CA	FAMILY PRACTICE	125	68	$7,956	$117	premium	48.6%	(831) 718-9701
4	CAPE FEAR VALLEY HEALTH MEDICAL GROUP LLC	FAYETTEVILLE	VA	PHYSICIAN ASSISTANT	280	40	$3,040	$76	premium	100.0%	(910) 829-6588
5	UROLOGY GROUP OF WESTERN NEW ENGLAND, P.C.	SPRINGFIELD	MA	UROLOGY	11	39	$3,630	$93	premium	60.9%	(413) 785-5321
6	UROLOGY GROUP OF WESTERN NEW ENGLAND, P.C.	SPRINGFIELD	NY	UROLOGY	11	31	$2,970	$96	premium	22.3%	(413) 785-5321
7	ADVANCED UROLOGY ASSOCIATES ENTERPRISES	SHREWSBURY	NJ	UROLOGY	18	23	$15,617	$679	premium	100.0%	(732) 741-5923
8	COMPREHENSIVE UROLOGIC CARE S C	LAKE BARRINGTON	IL	PHYSICIAN ASSISTANT	14	18	$3,600	$200	premium	100.0%	(847) 382-5080
9	ARIZONA DIGESTIVE HEALTH PC	GLENDALE	AZ	GASTROENTEROLOGY	132	16	$2,944	$184	premium	100.0%	(602) 843-1265
10	SSM MEDICAL GROUP INC	SAINT LOUIS	MO	NURSE PRACTITIONER	547	14	$1,148	$82	premium	100.0%	(314) 645-6450
11	UROLOGY PARTNERS OF NORTH TEXAS, PLLC	ARLINGTON	TX	UROLOGY	89	11	$3,229	$294	premium	9.7%	—

*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 →