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

Q4018 Cast supplies, long arm splint, adult (11 years +), fiberglass HCPCS · Medical/Surgical Supplies dme

Classification DME › Medical/Surgical Supplies (CMS RBCS)

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

National scale 446 services ▲ 33.9% YoY · 367 beneficiaries (CY2024, Medicare FFS)

Medicare paid $6K · $13.43 avg / service, national

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

Billing groups

Named-group FFS services

365

FFS of Medicare

49%

Services YoY

+33.9%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~740 services

365 observed fee-for-service (49%) · ~375 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 — Q4018 (CY2024)

CA 173 FL 79 SC 38 NY 28 VA 24

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

Named-group submitted charges

$16K

Named-group allowed amount

$6K

Named-group Medicare payments

$5K

Avg charge / svc

$45

Avg allowed / svc

$17

Avg payment / svc

$13

Average charge per group

$13–25

$25–37

$37–49

$49–62

$62–74

$74–86

$86–98

$98+

$13 16 groups · avg submitted charge / service $189

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 Q4018 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	Q4018 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	ORTHOPEDIC INSTITUTE OF NEWPORT BEACH LIMITED PARTNERSHIP	NEWPORT BEACH	CA	PHYSICIAN ASSISTANT	30	61	$2,745	$45	premium	35.3%	(949) 722-7038
2	SCRIPPS HEALTH	LA JOLLA	CA	PHYSICIAN ASSISTANT	1431	39	$1,469	$38	premium	22.5%	(858) 455-9100
3	COASTAL ORTHOPEDICS AND SPORTS MEDICINE OF SOUTHWEST FLORIDA PA	BRADENTON	FL	PHYSICIAN ASSISTANT	62	26	$780	$30	premium	32.9%	(941) 792-1404
4	VANN-VIRGINIA CENTER FOR ORTHOPAEDICS PC	VIRGINIA BEACH	VA	PHYSICIAN ASSISTANT	67	24	$480	$20	premium	100.0%	(757) 321-3300
5	ORTHOSC LLC	MYRTLE BEACH	SC	PHYSICAL THERAPIST IN PRIVATE PRACTICE	113	23	$828	$36	premium	60.5%	(843) 491-4937
6	CENTER FOR ORTHOPAEDICS AND SPINE LLC	LAKE CHARLES	LA	NURSE PRACTITIONER	32	22	$1,056	$48	premium	100.0%	(337) 721-7236
7	ADVANCED ORTHOPEDICS OF OKLAHOMA PLLC	TULSA	OK	PHYSICAL THERAPIST IN PRIVATE PRACTICE	89	21	$1,061	$51	premium	100.0%	(918) 494-2665
8	NORTH FLORIDA SURGEONS PA	JACKSONVILLE	FL	PHYSICIAN ASSISTANT	331	20	$600	$30	premium	25.3%	(904) 396-1725
9	THE ORTHOPAEDIC GROUP PC	MOBILE	AL	ORTHOPEDIC SURGERY	69	20	$260	$13	premium	100.0%	(251) 476-5050
10	ARCH HEALTH PARTNERS INC	POWAY	CA	PHYSICIAN ASSISTANT	161	18	$684	$38	premium	10.4%	(858) 485-0050
11	SOUTHEAST ORTHOPEDIC SPECIALISTS LLC	JACKSONVILLE	FL	PHYSICIAN ASSISTANT	143	18	$630	$35	premium	22.8%	(904) 634-0640
12	BOWEN HEFLEY RHODES STEWART ORTHOPEDICS, PA	NORTH LITTLE ROCK	AR	ORTHOPEDIC SURGERY	19	17	$340	$20	premium	100.0%	—
13	ORTHOPAEDIC SPECIALTY INSTITUTE MEDICAL GROUP OF ORANGE COUNTY	ORANGE	CA	PHYSICIAN ASSISTANT	58	16	$1,120	$70	premium	9.2%	(714) 634-4567
14	REGENTS OF THE UNIVERSITY OF CALIFORNIA	LOS ANGELES	CA	ORTHOPEDIC SURGERY	136	16	$3,024	$189	premium	9.2%	(310) 443-8999
15	SPORTS MEDICINE NORTH ORTHOPAEDIC SURGERY, INC.	PEABODY	MA	PHYSICIAN ASSISTANT	87	13	$1,092	$84	premium	100.0%	(978) 818-6350
16	TENNESSEE ORTHOPAEDIC ALLIANCE PA	NASHVILLE	TN	PHYSICIAN ASSISTANT	352	11	$264	$24	premium	100.0%	(615) 329-6600

*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 →