Medicare procedure market data by CPT code & state

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

96921 Treatment of inflammatory skin disease using laser, 250.0-500.0 sq cm CPT · Skin procedure

Classification Procedure › Skin (CMS RBCS)

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

National scale 17,237 services · est. ▲ 2.7% YoY · 907 FFS beneficiaries (CY2024, all-Medicare estimate) — 8,537 observed fee-for-service services

Medicare paid $2.4M · est. · $142.28 avg / service, national — $1.2M observed FFS

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.

13,367

Scaled from 6,565 observed FFS services.

FFS of Medicare

49%

Payer-mix frame

Services · year over year

Services YoY

+2.7%

All-Medicare est. · observed FFS +0.9%

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

Estimated all-Medicare volume estimate

FFS + estimated MA

~13,367 services

6,565 observed fee-for-service (49%) · ~6,802 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 — 96921 (CY2024)

CA 6,442 NY 3,972 MN 1,472 FL 1,448 MD 992

Est. all-Medicare services by billing state (scaled estimate — assumes MA utilization mirrors FFS); open a bar for that state's ranked market.

Billed → allowed → paid

Named-group submitted charges

$2.5M

Named-group allowed amount

$1.2M

Named-group Medicare payments

$1.9M · est.

— $936K observed FFS

Avg charge / svc

$375

Avg allowed / svc

$182

Avg payment / svc

$143

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

Average charge per group

$212–258

$258–303

$303–349

$349–395

$395–440

$440–486

$486–532

$532+

$212 19 groups · avg submitted charge / service $599

Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — each panel renders gated on the free tier.

See it in full: nuclear heart imaging (78452) in Arizona is open as a live example — every paid panel, on real data.

View the live example →

Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 96921 services, highest first, CY2024
#	Physician group locked column	City locked column	St locked column	Specialty locked column	Providers locked column	96921 svcs	Submitted charges locked column	Avg charge locked column	Medicare $ locked column	Share of state* locked column	Phone
1	ADVANCED DERMATOLOGY CARE INC	SAN RAMON	CA	PHYSICIAN ASSISTANT	8	972	$458,784	$472	premium	30.6%	—
2	JOHNS HOPKINS UNIVERSITY	BALTIMORE	MD	NURSE PRACTITIONER	2900	754	$188,500	$250	premium	100.0%	(410) 502-4340
3	ARRAY SKIN THERAPY A MEDICAL CORPORATION	MISSION VIEJO	CA	NURSE PRACTITIONER	11	650	$222,580	$342	premium	20.5%	(714) 313-9668
4	INFINITE MEDICAL PC	LAKELAND	NY	NURSE PRACTITIONER	87	618	$200,729	$325	premium	32.5%	(212) 734-6621
5	TAREEN DERMATOLOGY PA	ROSEVILLE	MN	PHYSICIAN ASSISTANT	42	598	$263,120	$440	premium	100.0%	(651) 633-6883

That's the top 5 of 19 groups. The platform ranks the whole market — code baskets, benchmarks, and the full ranked list. the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

*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 — and the observed foundation every market figure here builds on. Market totals anchor on a labeled all-Medicare estimate scaled from that foundation, with the observed count disclosed beside it — Medicare only, never all-payer. Modeled all-payer databases project every payer statistically and typically run higher. Same market, different denominator. How the numbers reconcile →