NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
45400 Repair of rectal prolapse using an endoscope CPT · Procedure
Classification Procedure Digestive/Gastrointestinal (CMS RBCS)
First observed 2014
National scale 247 services ▲ 48.8% YoY · 247 beneficiaries (CY2024, Medicare FFS)
Medicare paid $222K · $897.97 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
12
Named-group FFS services
217
FFS of Medicare
49%
Services YoY
+48.8%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~454 services

217 observed fee-for-service (48%) · ~237 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 — 45400 (CY2024)

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

Named-group submitted charges
$981K
Named-group allowed amount
$240K
Named-group Medicare payments
$192K
Avg charge / svc
$4,521
Avg allowed / svc
$1,108
Avg payment / svc
$885
Average charge per group
$2,448 12 groups · avg submitted charge / service $9,333
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 45400 services, highest first, CY2024
# Physician group activate to sort City activate to sort St activate to sort Specialty activate to sort Providers activate to sort 45400 svcs sorted descending — activate to reverse Submitted charges activate to sort Avg charge activate to sort Medicare $ locked column Share* activate to sort Phone
1 BHS PHYSICIANS NETWORK, INC SAN ANTONIO TX PHYSICIAN ASSISTANT 696 32 $103,520 $3,235 premium 100.0% (210) 614-7414
2 FLORIDA HOSPITAL MEDICAL GROUP INC MAITLAND FL PHYSICIAN ASSISTANT 1634 26 $90,818 $3,493 premium 60.5% (407) 200-2700
3 NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC ATLANTA GA PHYSICIAN ASSISTANT 368 17 $58,089 $3,417 premium 100.0%
4 MAYO CLINIC ROCHESTER MN NURSE PRACTITIONER 4896 17 $123,869 $7,286 premium 58.6% (507) 284-2511
5 SAINT FRANCIS PHYSICIAN NETWORK, LLC MEMPHIS NE PHYSICIAN ASSISTANT 75 17 $54,995 $3,235 premium 100.0% (901) 680-9205
6 VIRGINIA MASON MEDICAL CENTER SEATTLE WA PHYSICIAN ASSISTANT 879 16 $59,138 $3,696 premium 53.3% (206) 223-6600
7 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 15 $75,990 $5,066 premium 100.0% (650) 723-4000
8 KADLEC REGIONAL MEDICAL CENTER RICHLAND WA PHYSICIAN ASSISTANT 382 14 $34,272 $2,448 premium 46.7% (509) 946-4611
9 UNIVERSITY PHYSICIANS INCORPORATED AURORA CO PHYSICIAN ASSISTANT 3122 14 $81,914 $5,851 premium 100.0% (720) 777-1234
10 NOVANT HEALTH MEDICAL GROUP COASTAL REGION LLC WILMINGTON NC PHYSICIAN ASSISTANT 560 13 $34,866 $2,682 premium 100.0% (910) 662-6000
11 WEILL MEDICAL COLLEGE OF CORNELL NEW YORK NY INTERNAL MEDICINE 2053 12 $112,000 $9,333 premium 100.0% (212) 746-5454
12 MASSACHUSETTS GENERAL PHYSICIANS ORGANIZATION INC BOSTON MN DIAGNOSTIC RADIOLOGY 3532 12 $76,587 $6,382 premium 41.4% (617) 724-0287
13 MASSACHUSETTS GENERAL PHYSICIANS ORGANIZATION INC BOSTON MA DIAGNOSTIC RADIOLOGY 3532 12 $75,024 $6,252 premium 100.0% (617) 724-0287

*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 →