NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
26210 Removal of cyst or growth of finger bone CPT · Musculoskeletal procedure
Classification Procedure › Musculoskeletal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 606 services · est. ▼ 13.9% YoY · 247 FFS beneficiaries (CY2024, all-Medicare estimate) — 295 observed fee-for-service services
Medicare paid $228K · est. · $380.86 avg / service, national — $112K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

9

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

322

Scaled from 156 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-13.9%

All-Medicare est. · observed FFS -21.1%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~322 services

156 observed fee-for-service (48%) · ~166 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 — 26210 (CY2024)
FL 146 CA 110 WA 94 OR 77 AR 29

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
$209K
Named-group allowed amount
$59K
Named-group Medicare payments
$95K · est.
— $46K observed FFS
Avg charge / svc
$1,341
Avg allowed / svc
$378
Avg payment / svc
$296
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
$413 9 groups · avg submitted charge / service $2,740
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 26210 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 SOUTHEAST ORTHOPEDIC SPECIALISTS LLC JACKSONVILLE FL PHYSICIAN ASSISTANT 143 28 $38,702 $1,382 43.8% (904) 634-0640
2 OLYMPIA ORTHOPAEDIC ASSOCIATES PLLC OLYMPIA WA PHYSICIAN ASSISTANT 109 22 $25,611 $1,164 45.8% —
3 GOLDEN STATE ORTHOPEDICS AND SPINE WALNUT CREEK CA ORTHOPEDIC SURGERY 190 21 $33,915 $1,615 38.9% (925) 939-8585
4 VENTURA ORTHOPEDICS MEDICAL GROUP INC VENTURA CA PHYSICIAN ASSISTANT 79 17 $19,295 $1,135 31.5% —
5 WESTERN ARKANSAS PLASTIC AND RECONSTRUCTIVE SURGERY CENTER FORT SMITH AR NURSE PRACTITIONER 2 16 $6,607 $413 100.0% (479) 709-8300
That's the top 5 of 9 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 — 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 →