NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
25607 Treatment of broken forearm bone on thumb side of wrist, above wrist, with placement of stabilizing device CPT · Musculoskeletal procedure
Classification Procedure › Musculoskeletal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 384 services ▼ 7.5% YoY · 381 beneficiaries (CY2024, Medicare FFS)
Medicare paid $885K · $2304.87 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

8

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

212

Scaled from 111 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+6.0%

All-Medicare est. · observed FFS -7.5%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~212 services

111 observed fee-for-service (52%) · ~101 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 — 25607 (CY2024)
CA 74 VA 49 NC 35 SC 30 FL 28

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

Billed → allowed → paid
Named-group submitted charges
$257K
Named-group allowed amount
$81K
Named-group Medicare payments
$64K
Avg charge / svc
$2,318
Avg allowed / svc
$731
Avg payment / svc
$579
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
$1,449 8 groups · avg submitted charge / service $4,200
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 25607 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 ROPER SAINT FRANCIS PHYSICIANS NETWORK CHARLESTON SC PHYSICIAN ASSISTANT 539 18 $38,142 $2,119 60.0% (843) 720-8448
2 ORTHOPEDIC INSTITUTE OF NEWPORT BEACH LIMITED PARTNERSHIP NEWPORT BEACH CA PHYSICIAN ASSISTANT 30 18 $38,160 $2,120 24.3% (949) 722-7038
3 MARTHA JEFFERSON MEDICAL GROUP LLC CHARLOTTESVILLE VA PHYSICIAN ASSISTANT 192 15 $21,741 $1,449 30.6% (434) 817-1020
4 GOLDEN STATE ORTHOPEDICS AND SPINE WALNUT CREEK CA ORTHOPEDIC SURGERY 190 14 $36,624 $2,616 18.9% (925) 939-8585
5 MIDWEST ORTHOPAEDIC CENTER S C PEORIA IL PHYSICIAN ASSISTANT 46 13 $28,821 $2,217 54.2% (309) 691-1400
That's the top 5 of 8 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 →

*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 →