NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
28313 Reconstruction of soft tissue angular deformity of toe CPT · Musculoskeletal procedure
Classification Procedure Musculoskeletal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 1,451 services ▼ 9.1% YoY · 831 beneficiaries (CY2024, Medicare FFS)
Medicare paid $416K · $286.82 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
19
Named-group FFS services
664
FFS of Medicare
49%
Services YoY
-9.1%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~1,330 services

664 observed fee-for-service (50%) · ~666 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 — 28313 (CY2024)

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Named-group submitted charges
$1.2M
Named-group allowed amount
$166K
Named-group Medicare payments
$131K
Avg charge / svc
$1,817
Avg allowed / svc
$250
Avg payment / svc
$197
Average charge per group
$635 19 groups · avg submitted charge / service $9,352
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 28313 services, highest first, CY2024
# Physician group activate to sort City activate to sort St activate to sort Specialty activate to sort Providers activate to sort 28313 svcs sorted descending — activate to reverse Submitted charges activate to sort Avg charge activate to sort Medicare $ locked column Share* activate to sort Phone
1 CENTERS FOR ADVANCED ORTHOPAEDICS LLC OLNEY VA PHYSICAL THERAPIST IN PRIVATE PRACTICE 596 75 $252,900 $3,372 premium 80.6% (301) 774-0500
2 COACHELLA VALLEY FOOT AND ANKLE INSTITUTE PALM DESERT CA PODIATRY 4 75 $85,551 $1,141 premium 16.4% (760) 848-8231
3 RENO ORTHOPAEDIC CLINIC LTD RENO NV ORTHOPEDIC SURGERY 95 64 $85,120 $1,330 premium 34.4% (775) 786-3040
4 BAY AREA FOOT CARE INC SAN FRANCISCO CA PODIATRY 125 59 $115,602 $1,959 premium 12.9% (415) 759-2014
5 ORTHOCAROLINA CHARLOTTE NC PHYSICIAN ASSISTANT 304 57 $73,416 $1,288 premium 33.5% (704) 323-2100
6 BAPTIST HEALTH MEDICAL GROUP INC LOUISVILLE KY NURSE PRACTITIONER 2448 35 $47,180 $1,348 premium 100.0% (502) 928-1050
7 ORTHOPAEDIC SPECIALTY INSTITUTE MEDICAL GROUP OF ORANGE COUNTY ORANGE CA PHYSICIAN ASSISTANT 58 34 $37,808 $1,112 premium 7.4% (714) 634-4567
8 REGENTS OF THE UNIV OF CA SACRAMENTO CA DIAGNOSTIC RADIOLOGY 1608 33 $65,967 $1,999 premium 7.2% (877) 827-7463
9 DUKE HEALTH INTEGRATED PRACTICE INC DURHAM CA PHYSICIAN ASSISTANT 3051 31 $39,308 $1,268 premium 6.8% (919) 684-8111
10 COMMUNITY ORTHOPEDIC MEDICAL GROUP MISSION VIEJO CA PHYSICIAN ASSISTANT 16 31 $48,763 $1,573 premium 6.8% (949) 348-4000
11 ARGOMED GROUP LLC OSPREY FL DIAGNOSTIC RADIOLOGY 13 24 $19,886 $829 premium 16.9% (941) 300-9111
12 CNOS PC SIOUX CITY IA PHYSICIAN ASSISTANT 99 22 $34,078 $1,549 premium 100.0% (712) 279-3500
13 MARK DRAKOS MD PLLC UNIONDALE NY NURSE PRACTITIONER 2 21 $196,400 $9,352 premium 100.0% (212) 606-1112
14 VERO ORTHOPAEDICS II PA VERO BEACH FL PHYSICIAN ASSISTANT 49 20 $17,020 $851 premium 14.1% (772) 257-3608
15 DR DAVID ELLIS DPM LLC RENO NV PODIATRY 2 19 $20,866 $1,098 premium 10.2% (775) 358-2542
16 ORTHOPEDIC INSTITUTE OF NORTH TEXAS PA FLOWER MOUND TX ORTHOPEDIC SURGERY 5 17 $25,701 $1,512 premium 100.0% (817) 200-6492
17 ORTHOSC LLC MYRTLE BEACH SC PHYSICAL THERAPIST IN PRIVATE PRACTICE 113 16 $19,840 $1,240 premium 22.2% (843) 491-4937
18 CATALYST ORTHOPAEDIC AND SPORTS MEDICINE INSTITUTE LLC BOISE ID ORTHOPEDIC SURGERY 2 16 $11,850 $741 premium 20.3% (208) 321-1209
19 SOUTH CAROLINA SPORTS MEDICINE AND ORTHOPAEDIC CENTER NORTH CHARLESTON SC PHYSICAL THERAPIST IN PRIVATE PRACTICE 43 15 $9,525 $635 premium 20.8% (843) 300-8585

*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 →