NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
45398 Banding of hemorrhoids using a flexible endoscope (colonoscope) CPT · Procedure
Classification Procedure › Digestive/Gastrointestinal › Lower GI Endoscopy - Other (CMS RBCS)
First observed 2015
National scale 2,009 services ▲ 24.3% YoY · 1,997 beneficiaries (CY2024, Medicare FFS)
Medicare paid $647K · $321.88 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

26

Named groups billing this code
Named-group FFS services

907

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+24.3%

FFS enrollment -2.2%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~1,735 services

907 observed fee-for-service (52%) · ~828 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 — 45398 (CY2024)
NE 453 CA 428 FL 275 TX 259 IL 110

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
$1.5M
Named-group allowed amount
$213K
Named-group Medicare payments
$167K
Avg charge / svc
$1,642
Avg allowed / svc
$235
Avg payment / svc
$184
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
$487 26 groups · avg submitted charge / service $9,895
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 45398 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 FAITH REGIONAL PHYSICIAN SERVICES LLC NORFOLK NE NURSE PRACTITIONER 185 279 $501,084 $1,796 61.6% (402) 371-4880
2 UNITED MEDICAL DOCTORS FALLBROOK CA GASTROENTEROLOGY 160 173 $259,500 $1,500 40.4% (760) 728-9560
3 ACCESS HEALTH CARE PHYSICIANS LLC SPRING HILL FL NURSE PRACTITIONER 179 67 $103,468 $1,544 24.4% (352) 688-8116
4 VASANTHA PAI MD PC BELLEVILLE IL GASTROENTEROLOGY 2 41 $65,600 $1,600 37.3% (618) 355-0880
5 FLORIDA HOSPITAL HEALTHCARE PARTNERS, INC DAYTONA BEACH FL PHYSICIAN ASSISTANT 588 32 $23,104 $722 11.6% (386) 231-6000
6 WEST TEXAS DIGESTIVE DISEASE CENTER P.A. LUBBOCK TX CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 10 31 $52,700 $1,700 12.0% (806) 788-4368
7 TROY GASTROENTEROLOGY PC ROCHESTER HILLS MI GASTROENTEROLOGY 44 19 $11,951 $629 40.4% (248) 844-9710
8 PHOEBE PHYSICIAN GROUP INC AMERICUS NM NURSE PRACTITIONER 442 19 $35,359 $1,861 100.0% (229) 928-2882
9 DOMINGO E GALLIANO JR PA PORT CHARLOTTE FL COLORECTAL SURGERY (PROCTOLOGY) 3 18 $25,296 $1,405 6.5% (941) 625-3411
10 MAUI MEDICAL GROUP INC WAILUKU HI PHYSICIAN ASSISTANT 68 18 $10,192 $566 46.2% (808) 242-6464
11 GASTROENTEROLOGY SPECIALISTS OF FREDERICK, P.A. FREDERICK MD GASTROENTEROLOGY 3 17 $16,830 $990 26.2% —
12 COLON - RECTAL SURGERY ASSOCIATES PC AIKEN SC COLORECTAL SURGERY (PROCTOLOGY) 2 17 $35,921 $2,113 38.6% (803) 648-1171
13 BORLAND GROOVER CLINIC, PA JACKSONVILLE FL GASTROENTEROLOGY 125 16 $20,240 $1,265 5.8% (904) 398-7205
14 DECATUR DIGESTIVE DISEASES PC DECATUR AL GASTROENTEROLOGY 6 14 $12,325 $880 43.8% (256) 351-2116
15 GI PARTNERS OF ILLINOIS LLC LIBERTYVILLE IL GASTROENTEROLOGY 36 14 $35,639 $2,546 12.7% (630) 952-1400
16 NEW YORK UNIVERSITY NEW YORK NY DIAGNOSTIC RADIOLOGY 5704 14 $138,530 $9,895 51.9% (212) 263-9700
17 GASTRO CENTER OF MARYLAND LLC COLUMBIA MI GASTROENTEROLOGY 22 13 $6,500 $500 27.7% (410) 290-6677
18 DREAMWORK MEDICAL, PLLC FLUSHING NY GASTROENTEROLOGY 2 13 $19,200 $1,477 48.1% (718) 886-6292
19 JOHN MUIR PHYSICIAN NETWORK WALNUT CREEK CA FAMILY PRACTICE 489 13 $25,415 $1,955 3.0% (925) 296-9720
20 TEXAS HEALTH PHYSICIANS GROUP FORT WORTH TX PHYSICIAN ASSISTANT 1350 12 $28,200 $2,350 4.6% (817) 281-2977
21 DIGESTIVE HEALTH ASSOCIATES RENO NV CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 36 12 $8,400 $700 44.4% (775) 829-7600
22 PROVIDENCE MEDICAL FOUNDATION FULLERTON CA PHYSICIAN ASSISTANT 1455 11 $8,162 $742 2.6% (714) 871-3006
23 INTERCOASTAL MEDICAL GROUP INC SARASOTA FL DIAGNOSTIC RADIOLOGY 187 11 $5,357 $487 4.0% (941) 366-1888
24 MORRIS HOSPITAL MORRIS IL NURSE PRACTITIONER 116 11 $8,800 $800 10.0% (815) 942-0545
25 ADVANCED GASTROENTEROLOGY OF NAPLES, LLC NAPLES FL CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 6 11 $5,434 $494 4.0% (239) 593-9599
26 WEST CENTRAL GASTROENTEROLOGY LLP CLEARWATER FL GASTROENTEROLOGY 83 11 $26,235 $2,385 4.0% (727) 347-0005

*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 →