NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
43280 Strengthening of muscle between esophagus and stomach by wrapping part of stomach around esophagus using an endoscope CPT · Procedure
Classification Procedure Digestive/Gastrointestinal Upper GI Endoscopy (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 121 services · est. ▼ 58.8% YoY · 69 FFS beneficiaries (CY2024, all-Medicare estimate) — 69 observed fee-for-service services
Medicare paid $101K · est. · $832.18 avg / service, national — $57K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Estimated all-Medicare volume estimate
FFS + estimated MA

~121 services

69 observed fee-for-service (57%) · ~52 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
Payments · FFS observed

$57K

all-Medicare ≈$101K — estimate; price parity assumed as well
Rate per 1,000 FFS

0.0

claims denominator · a rate — never scaled
Named groups

4

4 at the ≥11-service disclosure floor
Top states — 43280 (CY2024)

Est. all-Medicare services by billing state (scaled estimate — assumes MA utilization mirrors FFS); open a bar for that state's ranked market.

The 12-year rate

Declining on the honest basis across 12 years

2013201420152016201720182019202020212022202320240.0
Per 1,000 FFS beneficiaries, claims denominator · the dated per-year table is a Platform view
What they charge

Half the field lists between $3,402 and $3,819

Submitted charges are provider-set list amounts, not payments · median $3,661 (named groups)
National benchmarkspremium

Computed for this market — a Platform view

Market positionpremium

Computed for this market — a Platform view

The whole field, one canvaspremium

Computed for this market — a Platform view

See it in full: nuclear heart imaging (78452) in Arizona is open as a live example — every paid panel, on real data.

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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column

sorts locked on the free tier · services rank pinned · refine and export are Platform features

1
JACKSON · MS · GENERAL SURGERY · 8 providers · hospital-affiliated · 6019481411147
18services 100.0%Share of state* $2,770avg list premiumMedicare $
2
PLAINSBORO · NJ · GENERAL SURGERY · 8 providers · hospital-affiliated ·
14services 100.0%Share of state* $3,612avg list premiumMedicare $
3
EVANSTON · IL · NURSE PRACTITIONER · 3380 providers · hospital-affiliated ·
14services 100.0%Share of state* $4,146avg list premiumMedicare $
4
COLUMBUS · OH · PHYSICIAN ASSISTANT · 204 providers · hospital-affiliated · (614) 293-2101
12services 100.0%Share of state* $3,710avg list premiumMedicare $

Medicare $ counts 43280 payments in the market each row names, CY2024; avg list is that row's submitted charges per service on the same basis — list amounts, not payments.

*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 →