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

93260 Programming of implantable defibrillator system CPT · Cardiography test

Classification Test › Cardiography › Electrocardiogram (CMS RBCS)

First observed 2015

National scale 93 services ▼ 70.6% YoY · 71 beneficiaries (CY2024, Medicare FFS)

Medicare paid $5K · $56.35 avg / service, national

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

Billing groups

Named-group FFS services

FFS of Medicare

49%

Services YoY

-70.6%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~126 services

63 observed fee-for-service (50%) · ~63 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 — 93260 (CY2024)

NY 45 IL 37 OH 11

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

Named-group submitted charges

$22K

Named-group allowed amount

$5K

Named-group Medicare payments

$4K

Avg charge / svc

$347

Avg allowed / svc

$79

Avg payment / svc

$56

Average charge per group

$171–208

$208–245

$245–281

$281–318

$318–355

$355–392

$392–429

$429+

$171 3 groups · avg submitted charge / service $495

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.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 93260 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	93260 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	STONY BROOK INTERNISTS UNIVERSITY FACULTY PRACTICE CORPORATION	STONY BROOK	NY	HOSPITALIST	414	33	$16,335	$495	premium	73.3%	(631) 444-1560
2	DUPAGE MEDICAL GROUP LTD	GLEN ELLYN	IL	PHYSICIAN ASSISTANT	1323	18	$3,076	$171	premium	48.6%	(630) 469-9200
3	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	NEW YORK	NY	PHYSICIAN ASSISTANT	2818	12	$2,440	$203	premium	26.7%	(212) 241-4812

*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 →