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

Q4045 Cast supplies, short leg splint, adult (11 years +), plaster 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 432 services ▲ 4.6% YoY · 337 beneficiaries (CY2024, Medicare FFS)

Medicare paid $4K · $10.32 avg / service, national

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

Billing groups

Named-group FFS services

259

FFS of Medicare

49%

Services YoY

+4.6%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~547 services

259 observed fee-for-service (47%) · ~288 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 — Q4045 (CY2024)

NC 70 IA 62 FL 51 WI 36 PA 33

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

Named-group submitted charges

$9K

Named-group allowed amount

$3K

Named-group Medicare payments

$3K

Avg charge / svc

$34

Avg allowed / svc

$13

Avg payment / svc

$10

Average charge per group

$12–19

$19–25

$25–32

$32–39

$39–46

$46–52

$52–59

$59+

$12 13 groups · avg submitted charge / service $75

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 Q4045 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	Q4045 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	NORTH FLORIDA SURGEONS PA	JACKSONVILLE	FL	PHYSICIAN ASSISTANT	331	37	$555	$15	premium	72.5%	(904) 396-1725
2	AURORA ADVANCED HEALTHCARE, INC.	MILWAUKEE	WI	DIAGNOSTIC RADIOLOGY	1093	36	$2,160	$60	premium	100.0%	(414) 352-3100
3	ORTHOPAEDIC ASSOCIATES OF MAINE PA	PORTLAND	ME	PHYSICIAN ASSISTANT	57	27	$1,539	$57	premium	100.0%	(207) 828-2101
4	OLYMPIA ORTHOPAEDIC ASSOCIATES PLLC	OLYMPIA	WA	PHYSICIAN ASSISTANT	109	19	$241	$13	premium	100.0%	—
5	ORTHOCAROLINA	CHARLOTTE	NC	PHYSICIAN ASSISTANT	304	18	$306	$17	premium	25.7%	(704) 323-2100
6	ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, LLC	TUPELO	MS	ORTHOPEDIC SURGERY	11	17	$714	$42	premium	100.0%	(662) 377-2663
7	ROTHMAN ORTHOPAEDICS OF NEW JERSEY, LLC	MARLTON	NJ	PHYSICIAN ASSISTANT	176	17	$374	$22	premium	100.0%	(800) 321-9999
8	LEHIGH VALLEY PHYSICIAN GROUP	ALLENTOWN	PA	PHYSICIAN ASSISTANT	2389	17	$510	$30	premium	51.5%	—
9	MACON ORTHOPAEDIC AND HAND CENTER, PA	MACON	GA	NURSE PRACTITIONER	87	16	$1,200	$75	premium	100.0%	(478) 745-4206
10	RENO ORTHOPAEDIC CLINIC LTD	RENO	NV	ORTHOPEDIC SURGERY	95	15	$180	$12	premium	100.0%	(775) 786-3040
11	ORTHOPEDIC INSTITUTE PC	SIOUX FALLS	SD	ORTHOPEDIC SURGERY	58	15	$450	$30	premium	100.0%	—
12	ST CHARLES HEALTH SYSTEM INC	BEND	OR	PHYSICIAN ASSISTANT	373	14	$188	$13	premium	100.0%	(541) 706-7715
13	MERCY HEALTH PHYSICIANS KENTUCKY SPECIALTY CARE LLC	PADUCAH	KY	NURSE PRACTITIONER	142	11	$437	$40	premium	100.0%	—

*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 →