NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
38589 Other procedure on lymphatic system using an 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 280 services · est. ▲ 143.2% YoY · 139 FFS beneficiaries (CY2024, all-Medicare estimate) — 141 observed fee-for-service services
Medicare paid $81K · est. · $289.55 avg / service, national — $41K 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.

219

Scaled from 109 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+143.5%

All-Medicare est. · observed FFS +131.1%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~219 services

109 observed fee-for-service (50%) · ~110 estimated Medicare Advantage.

Billing for this code concentrates in one state — scaled by the national payer mix (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale
Top states — 38589 (CY2024)
TX 133 CA 67 KS 42 NY 38

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
$212K
Named-group allowed amount
$46K
Named-group Medicare payments
$74K · est.
— $37K observed FFS
Avg charge / svc
$1,941
Avg allowed / svc
$422
Avg payment / svc
$336
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
$847 3 groups · avg submitted charge / service $2,197
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 38589 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS DALLAS TX PHYSICIAN ASSISTANT 3200 62 $136,226 $2,197 100.0% (214) 633-5555
2 WICHITA SURGICAL SPECIALISTS PA WICHITA KS GENERAL SURGERY 60 28 $59,245 $2,116 100.0% (316) 263-0296
3 CITY OF HOPE MEDICAL FOUNDATION DUARTE CA NURSE PRACTITIONER 942 19 $16,100 $847 57.6% (626) 256-4673

*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 →