Post-COVID Procedure Trends & Site-of-Service Migration
CMS Medicare Physician PUF | 3.4 Billion Services | 2019–2023
See what's growing, what's moving, and where
Key Insights
The Big Picture
Medicare FFS procedure volume hit 3.41 billion services in 2023, up 3.5% from 2019. But the recovery from COVID didn't just restore the old pattern — it changed the mix. Facility-based services declined 16% (563M → 471M), while office-based services grew 8% (2.73B → 2.94B). The shift to outpatient and office settings is accelerating.
What's Driving Growth
Physical therapy is the standout — therapeutic activities (97530) and neuromuscular re-education (97112) together added +29M services. Remote patient monitoring codes exploded +3,500%. Meanwhile, 1,020 new procedure codes emerged since 2019, dominated by specialty drugs and COVID-era telehealth/testing.
Site-of-Service Migration
Wound care, imaging, and diagnostic procedures are rapidly migrating from facilities to office settings. Skin substitute grafts (15271) shifted 41 percentage points toward office. Surgery category volumes are flat, but the office share is growing — signaling that less complex surgical procedures are moving to lower-cost settings.
Geographic Variation
Growth is uneven. Idaho (+56%), Illinois (+41%), and Alaska (+32%) saw the biggest jumps — often driven by therapy and testing code expansion. Meanwhile, West Virginia (−32%), Maine (−17%), and Kentucky (−14%) saw significant declines, possibly reflecting population shifts and provider supply constraints.
Total Service Volume Trend
Facility vs Office Volume Trend
Top 15 Fastest-Growing Procedures
Top 10 Procedures: 5-Year Trend
Service Category Mix (2023)
Biggest Shifts to Office (% Points)
State-by-State Growth: Top 20 (2019-2023)
Surgery Category: Facility vs Office Trend
New & Emerging Procedures Since 2019 (Top 20)
| Code | Description | First Year | 2023 Volume | Beneficiaries | Drug? |
|---|---|---|---|---|---|
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Top Procedure Decliners (Top 10)
| Code | Description | 2019 Volume | 2023 Volume | Change | % Change |
|---|---|---|---|---|---|
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State Growth Rankings (Top 15)
| State | 2019 Volume | 2023 Volume | Growth % |
|---|---|---|---|
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