NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
50386 Removal of stent in ureter through ureter with review by radiologist CPT · Other Organ Systems procedure
Classification Procedure › Other Organ Systems (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 433 services · est. ▲ 10.2% YoY · 212 FFS beneficiaries (CY2024, all-Medicare estimate) — 217 observed fee-for-service services
Medicare paid $226K · est. · $536.87 avg / service, national — $117K 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.

293

Scaled from 154 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+10.2%

All-Medicare est. · observed FFS +9.6%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~293 services

154 observed fee-for-service (53%) · ~139 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 — 50386 (CY2024)
CA 87 PA 74 MI 52 FL 39 IL 38

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
$308K
Named-group allowed amount
$96K
Named-group Medicare payments
$139K · est.
— $77K observed FFS
Avg charge / svc
$2,003
Avg allowed / svc
$625
Avg payment / svc
$498
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
$625 7 groups · avg submitted charge / service $4,185
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 50386 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 UNIVERSITY OF PENN - MEDICAL GROUP PHILADELPHIA PA PHYSICIAN ASSISTANT 3505 35 $21,867 $625 100.0% (215) 662-2777
2 GREATER BOSTON UROLOGY LLC FRAMINGHAM MD UROLOGY 42 27 $72,400 $2,681 100.0% —
3 ILLINOIS UROLOGIC HEALTH SURGEONS SC PERU IL UROLOGY 10 22 $22,000 $1,000 100.0% (815) 664-5367
4 MICHAEL P. ZAHALSKY, MD PA CORAL SPRINGS FL UROLOGY 13 17 $40,120 $2,360 100.0% (954) 714-8200
5 ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI NEW YORK NY PHYSICIAN ASSISTANT 2818 17 $52,190 $3,070 100.0% (212) 241-4812
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 →