NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
31240 Removal of nasal breathing passages using an endoscope CPT · Other Organ Systems procedure
Classification Procedure › Other Organ Systems › Nasal/Sinus Endoscopy (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 893 services · est. ▲ 79.3% YoY · 344 FFS beneficiaries (CY2024, all-Medicare estimate) — 435 observed fee-for-service services
Medicare paid $182K · est. · $202.95 avg / service, national — $88K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

11

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

281

Scaled from 141 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+79.3%

All-Medicare est. · observed FFS +74.0%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~281 services

141 observed fee-for-service (50%) · ~140 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 — 31240 (CY2024)
FL 176 CA 158 TN 90 TX 67 LA 61

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
$130K
Named-group allowed amount
$16K
Named-group Medicare payments
$25K · est.
— $13K observed FFS
Avg charge / svc
$925
Avg allowed / svc
$112
Avg payment / svc
$89
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
$331 11 groups · avg submitted charge / service $2,860
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 31240 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 MAYO CLINIC JACKSONVILLE JACKSONVILLE FL NURSE PRACTITIONER 1587 17 $14,370 $845 22.1% (904) 953-2000
2 MURFREESBORO MEDICAL CLINIC, P.A. MURFREESBORO TN NURSE PRACTITIONER 172 16 $14,560 $910 37.2% (615) 867-7925
3 ENT AND ALLERGY ASSOCIATES OF FLORIDA, LLC BOCA RATON FL OTOLARYNGOLOGY 231 15 $13,354 $890 19.5% (561) 391-3333
4 HEAD AND NECK SURGERY OF KANSAS CITY P A OVERLAND PARK KS OTOLARYNGOLOGY 11 13 $10,288 $791 32.5% (913) 599-4800
5 MIDWEST SINUS SLEEP AND ALLERGY ASSOCIATES, LLC MOUNT VERNON IL OTOLARYNGOLOGY 12 12 $5,796 $483 52.2% (618) 628-0715
That's the top 5 of 11 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 →