NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
28740 Fusion of foot in midfoot region CPT · Musculoskeletal procedure
Classification Procedure › Musculoskeletal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 439 services · est. ▼ 17.8% YoY · 221 FFS beneficiaries (CY2024, all-Medicare estimate) — 225 observed fee-for-service services
Medicare paid $336K · est. · $822.36 avg / service, national — $185K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

8

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

304

Scaled from 148 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-17.8%

All-Medicare est. · observed FFS -18.8%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~304 services

148 observed fee-for-service (49%) · ~156 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 — 28740 (CY2024)
CA 93 IA 86 CO 58 TX 49 PA 47

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
$247K
Named-group allowed amount
$51K
Named-group Medicare payments
$82K · est.
— $40K observed FFS
Avg charge / svc
$1,667
Avg allowed / svc
$348
Avg payment / svc
$272
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
$1,015 8 groups · avg submitted charge / service $3,538
Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — each panel renders gated on the free tier.

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 28740 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 GRAND VALLEY ORTHOPEDICS GRAND JUNCTION CO PHYSICIAN ASSISTANT 29 28 $28,421 $1,015 100.0% —
2 ROBERT NEVILLE AND ASSOCIATES PA SHENANDOAH TX PODIATRY 5 23 $50,537 $2,197 100.0% (281) 364-9041
3 UNITED HOSPITAL CENTER INC BRIDGEPORT PA PHYSICIAN ASSISTANT 298 22 $24,654 $1,121 100.0% (681) 342-1842
4 DESERT ORTHOPEDIC CENTER A MEDICAL GROUP INC RANCHO MIRAGE CA PHYSICIAN ASSISTANT 50 22 $25,198 $1,145 47.8% (760) 340-3911
5 LANCE E HARDISON DPM PC OKLAHOMA CITY OK PODIATRY 2 15 $26,502 $1,767 100.0% (405) 751-6152
That's the top 5 of 8 groups. The platform ranks the whole market — code baskets, benchmarks, and the full ranked list. the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

*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 →