NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
33426 Repair of mitral valve with artificial valve on heart-lung machine CPT · Cardiovascular procedure
Classification Procedure › Cardiovascular (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 649 services · est. ▼ 25.1% YoY · 317 FFS beneficiaries (CY2024, all-Medicare estimate) — 317 observed fee-for-service services
Medicare paid $982K · est. · $1523.77 avg / service, national — $483K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

9

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

496

Scaled from 229 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-25.1%

All-Medicare est. · observed FFS -28.6%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~496 services

229 observed fee-for-service (46%) · ~267 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 — 33426 (CY2024)
OH 190 CA 185 NY 69 FL 68 MD 37

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
$2.3M
Named-group allowed amount
$451K
Named-group Medicare payments
$777K · est.
— $360K observed FFS
Avg charge / svc
$9,843
Avg allowed / svc
$1,969
Avg payment / svc
$1,573
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
$4,695 9 groups · avg submitted charge / service $17,915
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 33426 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 72 $1,012,752 $14,066 85.7% —
2 CEDARS-SINAI MEDICAL CENTER WEST HOLLYWOOD CA NURSE PRACTITIONER 802 55 $423,638 $7,703 60.4% (310) 423-3277
3 ST JOSEPHS MEDICAL PC LIVERPOOL NY PHYSICIAN ASSISTANT 378 22 $103,290 $4,695 66.7% (315) 475-8402
4 SMH PHYSICIAN SERVICES INC SARASOTA FL PHYSICIAN ASSISTANT 766 18 $132,966 $7,387 60.0% —
5 THE EMORY CLINIC INC ATLANTA GA NURSE PRACTITIONER 3484 15 $268,725 $17,915 100.0% (404) 778-7525
That's the top 5 of 9 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 →