NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
27054 Removal of hip joint lining CPT · Musculoskeletal procedure
Classification Procedure › Musculoskeletal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 685 services ▲ 26.4% YoY · 625 beneficiaries (CY2024, Medicare FFS)
Medicare paid $118K · $171.64 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

337

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+26.4%

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

~704 services

337 observed fee-for-service (48%) · ~367 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 — 27054 (CY2024)
TX 319 CA 311 NM 31 FL 13 CO 11

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
$387K
Named-group allowed amount
$36K
Named-group Medicare payments
$28K
Avg charge / svc
$1,148
Avg allowed / svc
$106
Avg payment / svc
$84
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
$815 6 groups · avg submitted charge / service $1,456
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 27054 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 RAMIN GANJIANPOUR MD INC MISSION HILLS CA PHYSICIAN ASSISTANT 4 18 $24,768 $1,376 5.8% (818) 361-0136
2 SAINT AGNES MEDICAL FOUNDATION FRESNO CA INTERNAL MEDICINE 155 24 $29,088 $1,212 7.7% (559) 450-5777
3 SUMMIT MEMORIAL MEDICAL GROUP LLC CASPER TX PHYSICIAN ASSISTANT 39 25 $26,902 $1,076 7.8% (307) 358-2122
4 ORTHOLONESTAR PLLC DALLAS TX PHYSICIAN ASSISTANT 407 25 $26,902 $1,076 7.8% (214) 220-2468
5 COMMUNITY FOUNDATION MEDICAL GROUP FRESNO CA PHYSICIAN ASSISTANT 292 121 $98,576 $815 38.9% —
6 TEXAS JOINT INSTITUTE, PLLC DALLAS TX PHYSICIAN ASSISTANT 39 124 $180,494 $1,456 38.9% (972) 566-5255

*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 →