NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
49320 Diagnostic exam of abdomen 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 674 services · est. ▲ 15.5% YoY · 333 FFS beneficiaries (CY2024, all-Medicare estimate) — 336 observed fee-for-service services
Medicare paid $113K · est. · $167.83 avg / service, national — $56K observed FFS
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.

507

Scaled from 251 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+15.6%

All-Medicare est. · observed FFS +8.4%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~507 services

251 observed fee-for-service (50%) · ~256 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 — 49320 (CY2024)
NJ 176 MN 165 TX 86 NY 63 NH 32

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

Billed → allowed → paid
Named-group submitted charges
$421K
Named-group allowed amount
$47K
Named-group Medicare payments
$78K · est.
— $38K observed FFS
Avg charge / svc
$1,677
Avg allowed / svc
$189
Avg payment / svc
$151
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
$780 7 groups · avg submitted charge / service $2,763
Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — each panel renders gated on the free tier.

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 49320 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 PRACTICE ASSOCIATES MEDICAL GROUP MORRISTOWN NJ NURSE PRACTITIONER 1404 80 $74,852 $936 76.2% (973) 971-5596
2 MAYO CLINIC ROCHESTER MN NURSE PRACTITIONER 4896 67 $185,121 $2,763 100.0% (507) 284-2511
3 SHARIF SURGICAL PLLC FORT WORTH TX PHYSICIAN ASSISTANT 2 40 $83,979 $2,099 100.0% (817) 332-0786
4 MAYO CLINIC ARIZONA PHOENIX AZ PHYSICIAN ASSISTANT 1635 14 $27,104 $1,936 100.0% (800) 603-0558
5 WHITE PLAINS PHYSICIAN SERVICES PC WHITE PLAINS NY PHYSICIAN ASSISTANT 383 14 $20,306 $1,450 46.7% (914) 681-0600
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 — 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 →