NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
43333 Repair of paraesophageal hernia with mesh implant through abdomen CPT · Procedure
Classification Procedure Digestive/Gastrointestinal (CMS RBCS)
First observed 2016
National scale 62 services · est. · 30 FFS beneficiaries (CY2024, all-Medicare estimate) — 31 observed fee-for-service services
Medicare paid $57K · est. · $912.45 avg / service, national — $28K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Estimated all-Medicare volume estimate
FFS + estimated MA

~62 services

31 observed fee-for-service (50%) · ~31 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
Payments · FFS observed

$28K

all-Medicare ≈$57K — estimate; price parity assumed as well
Rate per 1,000 FFS

0.0

claims denominator · a rate — never scaled
Named groups

2

2 at the ≥11-service disclosure floor
Top states — 43333 (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 9-year rate

Growing on the honest basis across 9 years

2016201720240.0
Per 1,000 FFS beneficiaries, claims denominator · the dated per-year table is a Platform view
What they charge

Half the field lists between $2,683 and $2,746

Submitted charges are provider-set list amounts, not payments · median $2,714 (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
ALBANY · NY · PHYSICIAN ASSISTANT · 480 providers · hospital-affiliated · (518) 525-1852
16services 100.0%Share of state* $2,778avg list premiumMedicare $
2
MURRAY · UT · PHYSICIAN ASSISTANT · 3944 providers · hospital-affiliated · (801) 261-8346
15services 100.0%Share of state* $2,651avg list premiumMedicare $

Medicare $ counts 43333 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 →