NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
27006 Incision of tendon of hip (abductor and/or extensor) CPT · Musculoskeletal procedure
Classification Procedure › Musculoskeletal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 464 services ▲ 27.8% YoY · 395 beneficiaries (CY2024, Medicare FFS)
Medicare paid $144K · $310.88 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

6

Named groups billing this code
Named-group FFS services

203

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+27.8%

FFS enrollment -2.2%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~433 services

203 observed fee-for-service (47%) · ~230 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 — 27006 (CY2024)
TX 350 MA 64 AZ 14 GA 13 NJ 12

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
$383K
Named-group allowed amount
$34K
Named-group Medicare payments
$27K
Avg charge / svc
$1,887
Avg allowed / svc
$169
Avg payment / svc
$135
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
$1,138 6 groups · avg submitted charge / service $9,674
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 27006 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 TEXAS JOINT INSTITUTE, PLLC DALLAS TX PHYSICIAN ASSISTANT 39 102 $117,114 $1,148 29.1% (972) 566-5255
2 SUMMIT MEMORIAL MEDICAL GROUP LLC CASPER TX PHYSICIAN ASSISTANT 39 32 $36,820 $1,151 9.1% (307) 358-2122
3 ORTHOLONESTAR PLLC DALLAS TX PHYSICIAN ASSISTANT 407 29 $32,994 $1,138 8.3% (214) 220-2468
4 THE SAN ANTONIO ORTHOPAEDIC GROUP LLP SAN ANTONIO TX PHYSICAL THERAPIST IN PRIVATE PRACTICE 138 15 $64,872 $4,325 4.3% (210) 804-5400
5 CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION LLC SUN CITY AZ PHYSICIAN ASSISTANT 254 14 $24,940 $1,781 100.0% (866) 974-2673
6 GREGORY MONTALBANO MD,PLLC STATEN ISLAND NY ORTHOPEDIC SURGERY 8 11 $106,414 $9,674 100.0% (718) 477-5479

*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 →