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

92986 Balloon dilation repair of aortic valve CPT · Cardiovascular procedure

Classification Procedure › Cardiovascular (CMS RBCS)

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

National scale 350 services ▼ 16.7% YoY · 350 beneficiaries (CY2024, Medicare FFS)

Medicare paid $365K · $1041.45 avg / service, national

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

Billing groups

Named-group FFS services

286

FFS of Medicare

49%

Services YoY

-16.7%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~571 services

286 observed fee-for-service (50%) · ~285 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 — 92986 (CY2024)

VA 96 NY 45 OH 42 MI 30 DC 25

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

Named-group submitted charges

$1.3M

Named-group allowed amount

$374K

Named-group Medicare payments

$298K

Avg charge / svc

$4,433

Avg allowed / svc

$1,307

Avg payment / svc

$1,044

Average charge per group

$2,290–3,056

$3,056–3,822

$3,822–4,588

$4,588–5,353

$5,353–6,119

$6,119–6,885

$6,885–7,651

$7,651+

$2,290 13 groups · avg submitted charge / service $8,667

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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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.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 92986 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	92986 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	SENTARA MEDICAL GROUP	NORFOLK	VA	PHYSICIAN ASSISTANT	1404	96	$238,284	$2,482	premium	100.0%	—
2	NEW YORK UNIVERSITY	NEW YORK	NY	DIAGNOSTIC RADIOLOGY	5704	29	$251,343	$8,667	premium	64.4%	(212) 263-9700
3	PROVIDENCE HEALTH AND SERVICES WASHINGTON	OLYMPIA	WA	FAMILY PRACTICE	477	20	$79,480	$3,974	premium	100.0%	(360) 493-4083
4	HENRY FORD HEALTH SYSTEM	DETROIT	MI	PHYSICIAN ASSISTANT	2536	19	$100,320	$5,280	premium	63.3%	(313) 916-2600
5	UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION, PC	BIRMINGHAM	AL	NURSE PRACTITIONER	2788	18	$104,778	$5,821	premium	100.0%	(205) 934-3460
6	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	NEW YORK	NY	NURSE PRACTITIONER	2273	16	$132,000	$8,250	premium	35.6%	(212) 305-8559
7	PREMIER HEALTH SPECIALISTS INC	DAYTON	OH	PHYSICIAN ASSISTANT	574	15	$55,725	$3,715	premium	35.7%	—
8	HEART SPECIALISTS OF SARASOTA PL	SARASOTA	OH	PHYSICIAN ASSISTANT	24	15	$40,431	$2,695	premium	35.7%	(941) 917-1000
9	ST VINCENT INFIRMARY MEDICAL CENTER	LITTLE ROCK	AR	NURSE PRACTITIONER	47	13	$29,770	$2,290	premium	100.0%	(501) 255-6000
10	CLEVELAND CLINIC	CLEVELAND	OH	PHYSICIAN ASSISTANT	6828	12	$88,140	$7,345	premium	28.6%	—
11	SPECTRUM HEALTH PRIMARY CARE PARTNERS	GRAND RAPIDS	MI	PHYSICIAN ASSISTANT	2255	11	$37,477	$3,407	premium	36.7%	(616) 885-5000
12	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	CA	INTERNAL MEDICINE	3716	11	$66,605	$6,055	premium	100.0%	(415) 600-1020
13	ENDEAVOR HEALTH MEDICAL GROUP	EVANSTON	IL	NURSE PRACTITIONER	3380	11	$43,351	$3,941	premium	47.8%	—

*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 →