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

97028 Application of ultraviolet light CPT · Treatment

Classification Treatment › Physical, Occupational, and Speech Therapy › PT Treatment (CMS RBCS)

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

National scale 6,235 services ▼ 15.5% YoY · 854 beneficiaries (CY2024, Medicare FFS)

Medicare paid $31K · $4.97 avg / service, national

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

Billing groups

Named-group FFS services

5,054

FFS of Medicare

49%

Services YoY

-15.5%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~10,154 services

5,054 observed fee-for-service (50%) · ~5,100 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 — 97028 (CY2024)

NY 2,842 CA 2,057 IA 489 IL 467 FL 306

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

Named-group submitted charges

$173K

Named-group allowed amount

$33K

Named-group Medicare payments

$25K

Avg charge / svc

$34

Avg allowed / svc

Avg payment / svc

Average charge per group

$7–12

$12–18

$18–23

$23–28

$28–34

$34–39

$39–45

$45–50

$7 11 groups · avg submitted charge / service $50

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 97028 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	97028 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	PANETTA PHYSICAL THERAPY PC	RONKONKOMA	NY	PHYSICAL THERAPIST IN PRIVATE PRACTICE	14	2,350	$117,500	$50	premium	82.7%	(631) 665-4560
2	STATE-OF-THE-ART PHYSICAL THERAPY, INC.	TUSTIN	CA	PHYSICAL THERAPIST IN PRIVATE PRACTICE	11	704	$5,600	$8	premium	34.2%	(714) 544-2188
3	MERCY MEDICAL CENTER	CEDAR RAPIDS	IA	ANESTHESIOLOGY	306	489	$7,012	$14	premium	100.0%	(319) 398-6011
4	STATE-OF-THE-ART PHYSICAL THERAPY, INC.	TUSTIN	FL	PHYSICAL THERAPIST IN PRIVATE PRACTICE	11	306	$2,310	$8	premium	100.0%	(714) 544-2188
5	SETH GREINER PT PLLC	SPEONK	NY	PHYSICAL THERAPIST IN PRIVATE PRACTICE	6	249	$12,450	$50	premium	8.8%	(631) 596-5096
6	ORANGE COUNTY PHYSICAL THERAPY OCPT INC	NEWPORT BEACH	CA	PHYSICAL THERAPIST IN PRIVATE PRACTICE	10	244	$1,708	$7	premium	11.9%	(949) 379-8400
7	AFFILIATED PODIATRISTS LTD	CHICAGO	IL	PODIATRY	4	158	$7,394	$47	premium	33.8%	(773) 202-8800
8	LIVESTRONG MEDICAL PLLC	MOKENA	IL	NURSE PRACTITIONER	13	154	$3,850	$25	premium	33.0%	(708) 691-4890
9	MEDCALF AND SCHOMMER PHYSICAL THERAPY	VISALIA	CA	PHYSICAL THERAPIST IN PRIVATE PRACTICE	2	151	$5,285	$35	premium	7.3%	(559) 625-9930
10	IVYREHAB PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH LANGUAGE PA	BROOKLYN	NY	PHYSICAL THERAPIST IN PRIVATE PRACTICE	375	106	$5,300	$50	premium	3.7%	(718) 230-1180
11	REDDY CARE PHYSICAL THERAPY PC	GREAT NECK	NY	PHYSICAL THERAPIST IN PRIVATE PRACTICE	133	69	$3,450	$50	premium	2.4%	(516) 829-0030
12	MERCY MEDICAL CENTER	CEDAR RAPIDS	NE	ANESTHESIOLOGY	306	49	$701	$14	premium	100.0%	(319) 398-6011
13	CAM PHYSICAL THERAPY AND WELLNESS SERVICES LLC	LAUREL	MD	PHYSICAL THERAPIST IN PRIVATE PRACTICE	7	25	$550	$22	premium	100.0%	3018530093105

*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 →