Medicare procedure market data by CPT code & state

Market snapshot

G0454 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

G0454 — Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist

Billing groups

Named-group FFS services

1,168

FFS of Medicare

49%

Services YoY

+27.3%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~2,546 services

1,168 observed fee-for-service (46%) · ~1,378 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 — G0454 (CY2024)

FL 610 TX 388 ME 146 NC 135 NE 79

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

Named-group submitted charges

$14K

Named-group allowed amount

$10K

Named-group Medicare payments

$8K

Avg charge / svc

$12

Avg allowed / svc

Avg payment / svc

Average charge per group

$8–10

$10–12

$12–14

$14–16

$16–18

$18–20

$20–22

$22+

$8 5 groups · avg submitted charge / service $25

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 exact payer split, and this market total scaled to all of Medicare, labeled as an estimate.

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 G0454 services, CY2024
#	Physician group	City	St	Specialty	Providers	G0454 svcs	Submitted charges	Avg charge	Medicare $ locked column	Share*	Phone
1	CENTRAL FLORIDA HOSPITALIST PARTNERS PA	ORLANDO	FL	HOSPITALIST	91	610	$6,100	$10	premium	100.0%	(407) 464-9516
2	CHRISTUS TRINITY CLINIC	TYLER	TX	NURSE PRACTITIONER	1495	280	$2,800	$10	premium	72.2%	(903) 606-5560
3	ESOP REHABILITATION LLC	CONYERS	NC	ORTHOPEDIC SURGERY	237	121	$2,178	$18	premium	89.6%	(770) 785-7669
4	HASTINGS INTERNAL MEDICINE ASSOCIATES PC	HASTINGS	NE	INTERNAL MEDICINE	6	79	$644	$8	premium	100.0%	(402) 463-2454
5	TRANQUILITY SLEEP SPECIALISTS PLC	KNOXVILLE	TN	NURSE PRACTITIONER	5	78	$1,950	$25	premium	100.0%	(865) 632-5627

*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 →