NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
51990 Suture suspension of urethra to control leakage using an endoscope 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 1,411 services ▲ 24.6% YoY · 1,411 beneficiaries (CY2024, Medicare FFS)
Medicare paid $329K · $232.90 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

19

Named groups billing this code
Named-group FFS services

801

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+24.6%

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

~1,675 services

801 observed fee-for-service (48%) · ~874 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 — 51990 (CY2024)
NY 313 CA 254 OH 247 TX 146 GA 58

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
$2.3M
Named-group allowed amount
$212K
Named-group Medicare payments
$168K
Avg charge / svc
$2,863
Avg allowed / svc
$264
Avg payment / svc
$210
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
$697 19 groups · avg submitted charge / service $8,593
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 51990 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI NEW YORK NY PHYSICIAN ASSISTANT 2818 238 $730,660 $3,070 76.0% (212) 241-4812
2 CENTRAL OHIO UROLOGY GROUP, LLC. GAHANNA OH UROLOGY 45 108 $232,505 $2,153 43.7% (614) 396-2684
3 TOWER UROLOGY INC LOS ANGELES CA UROLOGY 13 82 $214,200 $2,612 32.3% 3108549898159
4 SUTTER VALLEY MEDICAL FOUNDATION SACRAMENTO CA DIAGNOSTIC RADIOLOGY 2420 61 $133,409 $2,187 24.0% (916) 681-8852
5 WEILL MEDICAL COLLEGE OF CORNELL NEW YORK NY INTERNAL MEDICINE 2053 40 $180,600 $4,515 12.8% (212) 746-5454
6 PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION SANTA MONICA CA PHYSICIAN ASSISTANT 287 40 $130,339 $3,258 15.7% (310) 829-6789
7 UNIVERSITY OF PITTSBURGH PHYSICIANS PITTSBURGH PA DIAGNOSTIC RADIOLOGY 4291 33 $69,333 $2,101 75.0% —
8 NEW YORK UNIVERSITY NEW YORK NY DIAGNOSTIC RADIOLOGY 5704 24 $206,232 $8,593 7.7% (212) 263-9700
9 TOWER UROLOGY INC LOS ANGELES AZ UROLOGY 13 21 $73,500 $3,500 47.7% 3108549898159
10 BEND MEMORIAL CLINIC PC BEND OR PHYSICIAN ASSISTANT 233 19 $69,502 $3,658 100.0% (541) 382-2811
11 CHRIST HOSPITAL MEDICAL SPECIALISTS LLC CINCINNATI OH OBSTETRICS/GYNECOLOGY 129 19 $28,785 $1,515 7.7% (513) 241-4774
12 PROVIDENCE MEDICAL INSTITUTE TORRANCE CA INTERNAL MEDICINE 339 18 $12,546 $697 7.1% (310) 303-7496
13 SPOKANE UROLOGY PLLC SPOKANE WA PHYSICIAN ASSISTANT 25 16 $20,512 $1,282 100.0% (509) 747-3147
14 UCSF HEALTH MEDICAL FOUNDATION REDWOOD CITY CA OBSTETRICS/GYNECOLOGY 39 12 $31,140 $2,595 4.7% (650) 701-1882
15 UROLOGY PARTNERS OF NORTH TEXAS, PLLC ARLINGTON TX UROLOGY 89 12 $21,048 $1,754 8.2% —
16 ADVANCED UROLOGY ASSOCIATES ENTERPRISES SHREWSBURY NJ UROLOGY 18 12 $48,468 $4,039 100.0% (732) 741-5923
17 LEXINGTON HEALTH INC WEST COLUMBIA SC NURSE PRACTITIONER 909 12 $27,304 $2,275 100.0% (803) 744-4900
18 MAGIC VALLEY UROLOGY PLLC TWIN FALLS ID UROLOGY 3 12 $21,528 $1,794 48.0% (208) 733-3404
19 OHIOHEALTH CORPORATION COLUMBUS OH PHYSICIAN ASSISTANT 2282 11 $25,652 $2,332 4.5% —
20 DUBOIS REGIONAL MEDICAL CENTER DU BOIS PA PHYSICIAN ASSISTANT 416 11 $15,917 $1,447 25.0% —

*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 →