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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
0569T Repair of valve between upper right and lower right chambers of heart (tricuspid valve) using prosthesis delivered via catheter, accessed through skin; initial prosthesis HCPCS · Cardiovascular procedure
Classification Procedure Cardiovascular (CMS RBCS)
First observed 2021
National scale 269 services ▲ 79.3% YoY · 262 beneficiaries (CY2024, Medicare FFS)
Medicare paid $277K · $1030.83 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
6
Named-group FFS services
146
FFS of Medicare
49%
Services YoY
+79.3%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~297 services

146 observed fee-for-service (49%) · ~151 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 — 0569T (CY2024)

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

Named-group submitted charges
$665K
Named-group allowed amount
$188K
Named-group Medicare payments
$150K
Avg charge / svc
$4,552
Avg allowed / svc
$1,290
Avg payment / svc
$1,028
Average charge per group
$2,758 6 groups · avg submitted charge / service $6,848
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 0569T 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 0569T 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 SWEDISH HEALTH SERVICES SEATTLE WA CARDIOVASCULAR DISEASE (CARDIOLOGY) 78 48 $201,739 $4,203 premium 72.7% (206) 386-6000
2 SCRIPPS HEALTH LA JOLLA CA PHYSICIAN ASSISTANT 1431 23 $63,434 $2,758 premium 32.4% (858) 455-9100
3 REGENTS OF THE UNIV OF CA SACRAMENTO CA DIAGNOSTIC RADIOLOGY 1608 23 $157,504 $6,848 premium 32.4% (877) 827-7463
4 IHC HEALTH SERVICES INC MURRAY UT PHYSICIAN ASSISTANT 3944 21 $75,390 $3,590 premium 100.0% (801) 261-8346
5 NCHMD INC NAPLES FL NEUROLOGY 515 17 $86,921 $5,113 premium 56.7% (239) 436-5100
6 VHS OUTPATIENT CLINICS INC PHOENIX AZ PHYSICIAN ASSISTANT 180 14 $79,660 $5,690 premium 25.0% (602) 274-6506

*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 →