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

G0523 Management of a new patient with dementia, moderate to high complexity, for use in cmmi model HCPCS · E&M

Classification E&M › Care Management/Coordination (CMS RBCS)

First observed 2024

National scale 8,887 services · 3,693 beneficiaries (CY2024, Medicare FFS)

Medicare paid $3.5M · $395.12 avg / service, national

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

Billing groups

Named-group FFS services

1,796

FFS of Medicare

49%

Services YoY

—

Estimated all-Medicare volume FFS + estimated MA estimate

~3,812 services

1,796 observed fee-for-service (47%) · ~2,016 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 — G0523 (CY2024)

CA 4,766 KY 3,183 MO 664 TX 231 NC 29

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

Named-group submitted charges

$1.2M

Named-group allowed amount

$700K

Named-group Medicare payments

$700K

Avg charge / svc

$651

Avg allowed / svc

$390

Avg payment / svc

$390

Average charge per group

$390–436

$436–481

$481–527

$527–572

$572–618

$618–663

$663–709

$709+

$390 3 groups · avg submitted charge / service $773

Market analyticsPlatform

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 G0523 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	G0523 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	EMPOWERME MEDICAL GROUP PC	BRENTWOOD	KY	NURSE PRACTITIONER	11	1,025	$599,625	$585	premium	32.2%	(877) 367-9772
2	J M GEISS DO APC	SANTA ANA	CA	NURSE PRACTITIONER	156	428	$333,450	$779	premium	9.0%	(855) 434-7763
3	J M GEISS DO APC	SANTA ANA	TX	NURSE PRACTITIONER	156	231	$175,890	$761	premium	100.0%	(855) 434-7763
4	EMPOWERME MEDICAL GROUP PC	BRENTWOOD	MO	NURSE PRACTITIONER	11	83	$48,555	$585	premium	12.5%	(877) 367-9772
5	AUTHORACARE COLLECTIVE	GREENSBORO	NC	NURSE PRACTITIONER	11	29	$11,310	$390	premium	100.0%	(336) 621-2500

*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 →