NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
31576 Biopsy of voice box using a flexible endoscope CPT · Other Organ Systems procedure
Classification Procedure › Other Organ Systems (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 103 services · est. ▲ 72.5% YoY · 56 FFS beneficiaries (CY2024, all-Medicare estimate) — 60 observed fee-for-service services
Medicare paid $17K · est. · $160.02 avg / service, national — $10K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

3

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

103

Scaled from 60 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+71.7%

All-Medicare est. · observed FFS +76.5%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~103 services

60 observed fee-for-service (58%) · ~43 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 — 31576 (CY2024)
NJ 42 MA 34 NY 27

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
$63K
Named-group allowed amount
$12K
Named-group Medicare payments
$17K · est.
— $10K observed FFS
Avg charge / svc
$1,052
Avg allowed / svc
$207
Avg payment / svc
$160
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
$610 3 groups · avg submitted charge / service $1,827
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 31576 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 MASSACHUSETTS EYE AND EAR ASSOCIATES, INC BOSTON MA OPHTHALMOLOGY 406 22 $13,420 $610 100.0% (617) 523-7900
2 RUTGERS HEALTH-RWJ NEUROSURGERY FACULTY NEW BRUNSWICK NJ PHYSICIAN ASSISTANT 192 14 $25,578 $1,827 56.0% (732) 828-3000
3 ENT AND ALLERGY ASSOCIATES LLP YONKERS NY OTOLARYNGOLOGY 429 13 $13,065 $1,005 100.0% (914) 963-8588
4 ENT AND ALLERGY ASSOCIATES LLP YONKERS NJ OTOLARYNGOLOGY 429 11 $11,055 $1,005 44.0% (914) 963-8588

*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 →