NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
43644 Bypass of stomach using an endoscope CPT · Procedure
Classification Procedure › Digestive/Gastrointestinal (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 166 services ▼ 49.5% YoY · 166 beneficiaries (CY2024, Medicare FFS)
Medicare paid $108K · $653.57 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

7

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

264

Scaled from 143 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-51.3%

All-Medicare est. · observed FFS -49.5%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~264 services

143 observed fee-for-service (54%) · ~121 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 — 43644 (CY2024)
KS 49 AR 36 MO 35 WI 22 OK 13

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Billed → allowed → paid
Named-group submitted charges
$888K
Named-group allowed amount
$130K
Named-group Medicare payments
$103K
Avg charge / svc
$6,210
Avg allowed / svc
$908
Avg payment / svc
$722
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
$1,000 7 groups · avg submitted charge / service $18,934
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 43644 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 KANSAS UNIVERSITY PHYSICIANS INC KANSAS CITY KS NURSE PRACTITIONER 1815 30 $30,000 $1,000 61.2% (913) 588-1227
2 ARKANSAS HEART HOSPITAL LLC LITTLE ROCK AR NURSE PRACTITIONER 83 24 $68,400 $2,850 66.7% (501) 664-5860
3 MERCY CLINIC SPRINGFIELD COMMUNITIES SPRINGFIELD MO PHYSICIAN ASSISTANT 1128 22 $80,352 $3,652 62.9% —
4 SURGICAL ASSOCIATES OF NEENAH, S.C. NEENAH WI GENERAL SURGERY 29 22 $416,546 $18,934 100.0% (920) 725-4527
5 KC BARIATRIC LLC LENEXA KS PHYSICIAN ASSISTANT 15 19 $114,000 $6,000 38.8% (913) 677-6319
That's the top 5 of 7 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. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →