NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
22858 Insertion of artificial upper spine disc anterior approach CPT · Musculoskeletal procedure
Classification Procedure › Musculoskeletal › Arthrodesis - Spine (CMS RBCS)
First observed 2015
National scale 259 services · est. ▼ 2.4% YoY · 126 FFS beneficiaries (CY2024, all-Medicare estimate) — 129 observed fee-for-service services
Medicare paid $90K · est. · $349.23 avg / service, national — $45K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

5

Named groups billing this code
Named-group all-Medicare svcs · est.

169

Scaled from 81 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-2.3%

All-Medicare est. · observed FFS -5.8%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~169 services

81 observed fee-for-service (48%) · ~88 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 — 22858 (CY2024)
CA 122 TX 47 CO 38 UT 31 MO 30

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

Billed → allowed → paid
Named-group submitted charges
$128K
Named-group allowed amount
$34K
Named-group Medicare payments
$57K · est.
— $27K observed FFS
Avg charge / svc
$1,582
Avg allowed / svc
$418
Avg payment / svc
$333
Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.
Average charge per group
$1,341 5 groups · avg submitted charge / service $2,500
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 22858 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 ORTHOPAEDIC SAN ANTONIO PLLC SAN ANTONIO TX PHYSICAL THERAPIST IN PRIVATE PRACTICE 29 22 $29,499 $1,341 100.0% (210) 775-6655
2 MONTEREY SPINE AND JOINT PC MONTEREY CA PHYSICAL THERAPIST IN PRIVATE PRACTICE 80 18 $25,998 $1,444 30.0% (831) 648-7200
3 CATHOLIC HEALTH INITIATIVES COLORADO WOODLAND PARK UT PHYSICIAN ASSISTANT 1266 15 $22,416 $1,494 100.0% (719) 776-4780
4 COLUMBIA ORTHOPAEDIC GROUP LLP COLUMBIA MO ORTHOPEDIC SURGERY 91 14 $20,230 $1,445 100.0% (573) 443-2402
5 COMMONS CLINIC MEDICAL GROUP, PC MARINA DEL REY CA ORTHOPEDIC SURGERY 21 12 $30,000 $2,500 20.0% (310) 437-7925

*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 →