NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
29065 Application of shoulder to hand cast CPT · Musculoskeletal procedure
Classification Procedure › Musculoskeletal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 298 services ▼ 8.9% YoY · 227 beneficiaries (CY2024, Medicare FFS)
Medicare paid $22K · $73.36 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

13

Named groups billing this code
Named-group FFS services

236

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-8.9%

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

~462 services

236 observed fee-for-service (51%) · ~226 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 — 29065 (CY2024)
CA 98 TN 33 MA 27 MS 20 WA 20

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
$65K
Named-group allowed amount
$22K
Named-group Medicare payments
$17K
Avg charge / svc
$276
Avg allowed / svc
$94
Avg payment / svc
$74
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
$105 13 groups · avg submitted charge / service $427
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 29065 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 CHATTANOOGA ORTHOPAEDIC GROUP, PC CHATTANOOGA TN PHYSICAL THERAPIST IN PRIVATE PRACTICE 72 33 $8,877 $269 100.0% (423) 624-2696
2 SPORTS MEDICINE NORTH ORTHOPAEDIC SURGERY, INC. PEABODY MA PHYSICIAN ASSISTANT 87 27 $8,154 $302 100.0% (978) 818-6350
3 NORTHWEST SURGICAL SPECIALISTS PC VANCOUVER WA PHYSICIAN ASSISTANT 114 20 $5,494 $275 100.0% (360) 487-1000
4 ORTHOPAEDIC CENTER OF S FLORIDA PLANTATION FL ORTHOPEDIC SURGERY 21 19 $5,738 $302 100.0% 95447363443101
5 SCRIPPS HEALTH LA JOLLA CA PHYSICIAN ASSISTANT 1431 18 $6,712 $373 18.4% (858) 455-9100
6 THE PHYSICIANS GROUP, LLC OKLAHOMA CITY OK NURSE PRACTITIONER 103 18 $3,042 $169 100.0% (405) 692-9300
7 KERN COUNTY HOSPITAL AUTHORITY BAKERSFIELD CA DIAGNOSTIC RADIOLOGY 262 18 $3,769 $209 18.4% —
8 COMMUNITY ORTHOPEDIC MEDICAL GROUP MISSION VIEJO CA PHYSICIAN ASSISTANT 16 17 $5,936 $349 17.3% (949) 348-4000
9 SUTTER VALLEY MEDICAL FOUNDATION SACRAMENTO CA DIAGNOSTIC RADIOLOGY 2420 16 $6,832 $427 16.3% (916) 681-8852
10 ORTHOPAEDIC AND SPINE CENTER OF THE ROCKIES PC FORT COLLINS CO PHYSICIAN ASSISTANT 144 15 $2,835 $189 100.0% (970) 493-0567
11 WAKEMED SPECIALISTS GROUP LLC RALEIGH NC PHYSICIAN ASSISTANT 860 12 $2,628 $219 100.0% (919) 350-7270
12 YUMA REGIONAL MEDICAL CENTER YUMA AZ PHYSICIAN ASSISTANT 388 12 $1,260 $105 100.0% (928) 336-1815
13 KANSAS ORTHOPAEDIC CENTER, PA WICHITA KS PHYSICIAN ASSISTANT 26 11 $3,916 $356 100.0% (316) 838-2020

*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 →