NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
28124 Partial removal of toe bone CPT · Musculoskeletal procedure
Classification Procedure › Musculoskeletal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 1,111 services ▼ 11.0% YoY · 858 beneficiaries (CY2024, Medicare FFS)
Medicare paid $276K · $248.82 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

19

Named groups billing this code
Named-group FFS services

303

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-11.0%

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

~584 services

303 observed fee-for-service (52%) · ~281 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 — 28124 (CY2024)
AL 168 CA 102 SC 88 MS 80 NM 64

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
$334K
Named-group allowed amount
$92K
Named-group Medicare payments
$71K
Avg charge / svc
$1,101
Avg allowed / svc
$303
Avg payment / svc
$234
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
$698 19 groups · avg submitted charge / service $2,430
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 28124 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 OGDEN CLINIC SPECIALTY SERVICES LLC OGDEN UT PHYSICIAN ASSISTANT 133 26 $22,542 $867 42.6% (801) 475-3800
2 OTERO COUNTY HOSPITAL ASSOCIATION ALAMOGORDO NM DIAGNOSTIC RADIOLOGY 236 25 $19,550 $782 39.1% (505) 439-6100
3 MEDSTAR MEDICAL GROUP II LLC WASHINGTON MD PHYSICIAN ASSISTANT 3707 24 $21,384 $891 100.0% (202) 429-2401
4 AFFILIATES IN FOOT CARE, PC WOBURN MA PODIATRY 3 19 $13,300 $700 43.2% (781) 979-0919
5 BRIGHT FOOT CLINIC PA SPRINGDALE AR PODIATRY 2 18 $14,400 $800 29.0% (479) 750-3131
6 GARY L CURSON PA SURFSIDE FL PATHOLOGY 2 18 $13,500 $750 31.0% (305) 865-2281
7 TRINITY HEALTH MINOT ND NURSE PRACTITIONER 296 17 $41,310 $2,430 100.0% (701) 418-8000
8 SOCAL FOOT CARE PC MURRIETA CA PODIATRY 29 15 $26,519 $1,768 14.7% (951) 698-4611
9 CEDARS-SINAI MEDICAL CARE FOUNDATION LOS ANGELES CA PHYSICIAN ASSISTANT 1699 15 $18,924 $1,262 14.7% (310) 423-0674
10 CAMPBELL CLINIC, PC GERMANTOWN TN ORTHOPEDIC SURGERY 225 14 $15,232 $1,088 100.0% (901) 759-3100
11 NYU LANGONE HOSPITALS NEW YORK NY NURSE PRACTITIONER 248 13 $10,050 $773 30.2% (212) 598-2454
12 PHYSICIANS FOOTCARE, LLC SUMTER SC PODIATRY 31 13 $10,400 $800 14.8% (803) 773-7000
13 BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC BOSTON MA PHYSICIAN ASSISTANT 2942 13 $27,557 $2,120 29.5% (617) 732-5500
14 NORTH TEXAS PODIATRY ASSOCIATES PA EULESS TX PODIATRY 3 13 $9,100 $700 100.0% (817) 283-5151
15 SHOAL CREEK FOOT AND ANKLE CENTER LLC JOPLIN MO PODIATRY 5 13 $9,076 $698 100.0% (417) 622-0648
16 INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC CONCORD NC PODIATRY 46 12 $11,265 $939 100.0% (704) 786-4482
17 GEORGIALINA PHYSICAL THERAPY ASSOCIATES LLC AUGUSTA GA ORTHOPEDIC SURGERY 460 12 $16,863 $1,405 100.0% (706) 945-0810
18 REGENTS OF THE UNIV OF CA SACRAMENTO CA DIAGNOSTIC RADIOLOGY 1608 12 $21,960 $1,830 11.8% (877) 827-7463
19 FAMILY FOOT AND ANKLE OF STUART PL STUART FL PODIATRY 4 11 $10,663 $969 19.0% (772) 221-1193

*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 →