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

93580 Repair of congenital abnormality in wall between upper heart chambers with implant CPT · Cardiovascular procedure

Classification Procedure › Cardiovascular › Percutaneous Transcatheterization (CMS RBCS)

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

National scale 280 services ▲ 100.0% YoY · 280 beneficiaries (CY2024, Medicare FFS)

Medicare paid $205K · $730.48 avg / service, national

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

Billing groups

Named-group FFS services

193

FFS of Medicare

49%

Services YoY

+100.0%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~396 services

193 observed fee-for-service (49%) · ~203 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 — 93580 (CY2024)

CA 67 NY 37 AZ 25 CO 22 TN 22

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

Named-group submitted charges

$789K

Named-group allowed amount

$175K

Named-group Medicare payments

$139K

Avg charge / svc

$4,089

Avg allowed / svc

$907

Avg payment / svc

$722

Average charge per group

$1,375–2,182

$2,182–2,989

$2,989–3,795

$3,795–4,602

$4,602–5,409

$5,409–6,216

$6,216–7,022

$7,022+

$1,375 16 groups · avg submitted charge / service $8,406

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.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 93580 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	93580 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	SCRIPPS HEALTH	LA JOLLA	CA	PHYSICIAN ASSISTANT	1431	14	$48,756	$3,483	premium	20.9%	(858) 455-9100
2	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	NEW YORK	NY	PHYSICIAN ASSISTANT	2818	14	$70,000	$5,000	premium	37.8%	(212) 241-4812
3	CEDARS-SINAI MEDICAL CENTER	WEST HOLLYWOOD	CA	NURSE PRACTITIONER	802	14	$43,478	$3,106	premium	20.9%	(310) 423-3277
4	MOUNT CARMEL HEALTHPROVIDERS TWO LLC	COLUMBUS	VA	NURSE PRACTITIONER	235	13	$28,691	$2,207	premium	100.0%	(614) 234-6000
5	MAYO CLINIC	ROCHESTER	MN	NURSE PRACTITIONER	4896	13	$109,278	$8,406	premium	100.0%	(507) 284-2511
6	MAYO CLINIC ARIZONA	PHOENIX	AZ	PHYSICIAN ASSISTANT	1635	12	$90,492	$7,541	premium	48.0%	(800) 603-0558
7	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	CA	INTERNAL MEDICINE	3716	12	$61,555	$5,130	premium	17.9%	(415) 600-1020
8	LEXINGTON HEALTH INC	WEST COLUMBIA	SC	NURSE PRACTITIONER	909	12	$34,008	$2,834	premium	100.0%	(803) 744-4900
9	PREMIER CARDIOLOGY INC	NEWPORT BEACH	CA	PHYSICIAN ASSISTANT	7	12	$16,500	$1,375	premium	17.9%	(949) 478-7373
10	POUDRE VALLEY MEDICAL GROUP LLC	COLORADO SPRINGS	CO	PHYSICIAN ASSISTANT	2390	11	$24,761	$2,251	premium	50.0%	—
11	SPECIALTY ASSOCIATES OF WEST HOUSTON PLLC	HOUSTON	TX	PHYSICIAN ASSISTANT	125	11	$36,145	$3,286	premium	100.0%	(281) 461-6830
12	MOUNTAIN VIEW HOSPITAL LLC	IDAHO FALLS	WA	PHYSICIAN ASSISTANT	267	11	$21,263	$1,933	premium	100.0%	(208) 535-4343
13	UNIVERSITY PHYSICIANS INCORPORATED	AURORA	CO	PHYSICIAN ASSISTANT	3122	11	$70,719	$6,429	premium	50.0%	(720) 777-1234
14	MAIN LINE HEALTHCARE	BRYN MAWR	PA	NURSE PRACTITIONER	1157	11	$29,150	$2,650	premium	100.0%	—
15	CLEVELAND CLINIC	CLEVELAND	OH	PHYSICIAN ASSISTANT	6828	11	$84,007	$7,637	premium	100.0%	—
16	SAINT THOMAS MEDICAL PARTNERS	NASHVILLE	TN	NURSE PRACTITIONER	591	11	$20,328	$1,848	premium	50.0%	(615) 269-4545

*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 →