NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
28225 Removal of scar tissue of tendon on top side of foot CPT · Musculoskeletal procedure
Classification Procedure › Musculoskeletal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 293 services · est. ▲ 64.4% YoY · 97 FFS beneficiaries (CY2024, all-Medicare estimate) — 146 observed fee-for-service services
Medicare paid $82K · est. · $280.94 avg / service, national — $41K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

2

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

56

Scaled from 28 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+64.6%

All-Medicare est. · observed FFS +58.7%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~56 services

28 observed fee-for-service (50%) · ~28 estimated Medicare Advantage.

Billing for this code concentrates in one state — scaled by the national payer mix (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale
Top states — 28225 (CY2024)
IL 206 CA 34 AZ 22

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
$34K
Named-group allowed amount
$4K
Named-group Medicare payments
$6K · est.
— $3K observed FFS
Avg charge / svc
$1,199
Avg allowed / svc
$136
Avg payment / svc
$109
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
$685 2 groups · avg submitted charge / service $1,532
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 28225 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 REGENTS OF THE UNIV OF CA SACRAMENTO CA DIAGNOSTIC RADIOLOGY 1608 17 $26,044 $1,532 100.0% (877) 827-7463
2 BANNER PHYSICIAN SPECIALISTS ARIZONA LLC SUN CITY AZ PHYSICIAN ASSISTANT 354 11 $7,535 $685 100.0% (623) 832-4000

*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 →