NEVVI Medicare utilization intelligence
+ Build a code basket
Market snapshot

PA CY2024

Medicare Part B FFS · CY2024 · as published by CMS
22511 Stabilization of lower spine bone CPT · Musculoskeletal procedure
Classification Procedure › Musculoskeletal › Percutaneous Vertebroplasty (CMS RBCS)
First observed 2015
National scale 339 services ▼ 17.3% YoY · 329 beneficiaries (CY2024, Medicare FFS)
Medicare paid $113K · $332.07 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window · National figures — the PA market is below
Market analyticsPlatform Methods →

The structure and trend panels below are live for everyone — free to look at. The rank & score analytics, baskets, and export are the platform.

The read
What am I looking at, in one breath?
The read Platform

In Pennsylvania, 2 groups bill 22511 — 36 fee-for-service services.

Unlock the Platform — the full read, every number below, code baskets, and export. Looking is free; the depth is paid. Notify me at launch →

The orienting line is free; the comparative synthesis — growth rank, concentration, and $/service against the national figure — unlocks with Platform.

The snapshot
The honest, real numbers — free, always.
Billing groups

2

Named groups billing this code in PA
Named-group FFS services

36

Attributable volume · fee-for-service
FFS of Medicare

46%

Payer-mix frame
Named-group coverage

43%

Of Pennsylvania’s disclosed Part B services (2024). The rest is billed by clinicians whose volume isn’t attributed to any group — they belong to several groups, or none. How attribution works →
Services · year over year
Services YoY

—

Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~76 services

36 observed fee-for-service (47%) · ~40 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
The market
How big, moving which way, worth how much.
Billed → allowed → paid
Named-group submitted charges
$50K
Named-group allowed amount
$14K
Named-group Medicare payments
$11K
Avg charge / svc
$1,377
Avg allowed / svc
$392
Avg payment / svc
$309
Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.
Per-service vs national + the payments trend unlock with Platform
Market trend — 12-year view
services 2015–2024
YearServices Services per 1,000 Part B FFS beneficiaries Medicare payments
2015 (introduction year) 40 0.0 $11,456
2016 67 0.1 $21,819
2017 38 0.0 $12,095
2018 74 0.1 $24,004
2019 61 0.0 $20,303
2020 (2020) 33 0.0 $11,001
2022 25 0.0 $7,634
2024 36 0.0 $11,137

CAGR 2016–2024: -7.5%/yr · CAGR excludes 2020 and the introduction year.

Rates are per 1,000 Part B fee-for-service beneficiaries in the market's geography. See Methods.

The structure
Who's in this market and how it's shaped.
Average charge per group
$1,233 2 groups · avg submitted charge / service $1,480
Market structure

Concentration is not shown for markets under 11 billing groups.

Of volume attributable to named groups, independents account for 0%; hospital-affiliated 100%.

Disclosed setting mix: 0% office · 100% facility.

HHI trend: (group rosters begin 2019)

Provider-setting count 2015 → 2024: 2 → 2 (+0%).

Named groups cover 100% of disclosed volume. CMS suppresses provider-code rows under 11 beneficiaries at the source; suppressed volume is excluded and cannot be estimated from this file. Volume shares describe the volume attributable to named groups; the coverage line above states how much of disclosed Medicare fee-for-service volume that is.

The opportunity
So where do I act?

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 →
Refine: group size any 5+ 25+ 100+ independent only
Filter results:

Email me this CSV

Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City Specialty Providers 22511 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 MISSION HEALTH COMMUNITY MULTISPECIALTY PROVIDERS LLC ASHEVILLE PHYSICIAN ASSISTANT 593 21 $31,080 $1,480 58.3% (828) 213-1740
2 DLP MARQUETTE PHYSICIAN PRACTICES INC MARQUETTE PHYSICIAN ASSISTANT 192 15 $18,498 $1,233 41.7% —

*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 →