NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
33213 Insertion of pacemaker pulse generator with existing dual leads CPT · Cardiovascular procedure
Classification Procedure › Cardiovascular › Pacemaker Insertion or Repair (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 159 services · est. ▲ 8.5% YoY · 73 FFS beneficiaries (CY2024, all-Medicare estimate) — 73 observed fee-for-service services
Medicare paid $42K · est. · $267.91 avg / service, national — $20K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

4

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

108

Scaled from 51 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+8.9%

All-Medicare est. · observed FFS +2.8%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~108 services

51 observed fee-for-service (47%) · ~57 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 — 33213 (CY2024)
FL 75 PA 30 NY 27 CA 26

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
$64K
Named-group allowed amount
$18K
Named-group Medicare payments
$30K · est.
— $14K observed FFS
Avg charge / svc
$1,265
Avg allowed / svc
$347
Avg payment / svc
$274
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
$836 4 groups · avg submitted charge / service $1,911
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 33213 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 UPMC ALTOONA REGIONAL HEALTH SERVICES, INC. ALTOONA PA PHYSICIAN ASSISTANT 190 14 $11,704 $836 100.0% (814) 941-8811
2 MAIMONIDES CARDIOLOGY FPP BROOKLYN NY CARDIOVASCULAR DISEASE (CARDIOLOGY) 43 13 $12,922 $994 100.0% (718) 283-7735
3 THE REGENTS OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES CA INTERNAL MEDICINE 1424 13 $24,838 $1,911 100.0% (310) 825-7922
4 NCHMD INC NAPLES FL NEUROLOGY 515 11 $15,026 $1,366 33.3% (239) 436-5100

*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 →