NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
19380 Surgical change to reconstructed breast CPT · Breast procedure
Classification Procedure Breast Mastectomy (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 828 services · est. ▼ 32.9% YoY · 351 FFS beneficiaries (CY2024, all-Medicare estimate) — 410 observed fee-for-service services
Medicare paid $765K · est. · $918.05 avg / service, national — $376K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Estimated all-Medicare volume estimate
FFS + estimated MA

~828 services

410 observed fee-for-service (50%) · ~418 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
Payments · FFS observed

$376K

all-Medicare ≈$765K — estimate; price parity assumed as well
Rate per 1,000 FFS

0.0

claims denominator · a rate — never scaled
Named groups

14

14 at the ≥11-service disclosure floor
Top states — 19380 (CY2024)

Est. all-Medicare services by billing state (scaled estimate — assumes MA utilization mirrors FFS); open a bar for that state's ranked market.

The 12-year rate

Declining on the honest basis across 12 years

2013201420152016201720182019202020212022202320240.0
Per 1,000 FFS beneficiaries, claims denominator · the dated per-year table is a Platform view
What they charge

Half the field lists between $2,784 and $5,816

Submitted charges are provider-set list amounts, not payments · median $3,952 (named groups)
National benchmarkspremium

Computed for this market — a Platform view

Market positionpremium

Computed for this market — a Platform view

The whole field, one canvaspremium

Computed for this market — a Platform view

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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column

sorts locked on the free tier · services rank pinned · refine and export are Platform features

1
BALTIMORE · MD · PHYSICIAN ASSISTANT · 337 providers · hospital-affiliated · (410) 663-8100
28services 100.0%Share of state* $3,805avg list premiumMedicare $
2
GREAT NECK · NY · PHYSICIAN ASSISTANT · 10 providers · hospital-affiliated · (516) 498-8400
23services 62.2%Share of state* $30,196avg list premiumMedicare $
3
NEW ORLEANS · LA · PHYSICIAN ASSISTANT · 15 providers · hospital-affiliated · (504) 899-2800
15services 27.3%Share of state* $6,400avg list premiumMedicare $
4
GARDEN CITY · NY · PLASTIC AND RECONSTRUCTIVE SURGERY · 41 providers · hospital-affiliated · (516) 629-3838
14services 37.8%Share of state* $1,507avg list premiumMedicare $
5
LOUISVILLE · KY · NURSE PRACTITIONER · 2448 providers · hospital-affiliated · (502) 928-1050
13services 100.0%Share of state* $2,584avg list premiumMedicare $

You are at the seam — 5 of 14 groups named.

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That's the top 5 of 14 groups. The platform ranks the whole market — code baskets, benchmarks, and the full ranked list. the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

Medicare $ counts 19380 payments in the market each row names, CY2024; avg list is that row's submitted charges per service on the same basis — list amounts, not payments.

*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 — and the observed foundation every market figure here builds on. Market totals anchor on a labeled all-Medicare estimate scaled from that foundation, with the observed count disclosed beside it — Medicare only, never all-payer. Modeled all-payer databases project every payer statistically and typically run higher. Same market, different denominator. How the numbers reconcile →