NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
52235 Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm CPT · Other Organ Systems procedure
Classification Procedure › Other Organ Systems › Cystourethroscopy (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 20,758 services · est. ▲ 6.6% YoY · 9,573 FFS beneficiaries (CY2024, all-Medicare estimate) — 10,585 observed fee-for-service services
Medicare paid $10.0M · est. · $484.93 avg / service, national — $5.1M observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

219

Named groups billing this code
Named-group all-Medicare svcs · est.

11,121

Scaled from 5,599 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+6.6%

All-Medicare est. · observed FFS +2.6%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~11,121 services

5,599 observed fee-for-service (50%) · ~5,522 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 — 52235 (CY2024)
FL 3,192 CA 1,534 NY 1,316 TX 1,277 IL 1,191

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
$7.9M
Named-group allowed amount
$1.5M
Named-group Medicare payments
$2.4M · est.
— $1.2M observed FFS
Avg charge / svc
$1,405
Avg allowed / svc
$273
Avg payment / svc
$214
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
$260 219 groups · avg submitted charge / service $9,327
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 52235 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 SUMMIT MEDICAL GROUP PA BERKELEY HEIGHTS NJ PHYSICIAN ASSISTANT 1183 136 $431,800 $3,175 28.5% (908) 273-4300
2 ADVANCED UROLOGY INSTITUTE LLC INVERNESS FL UROLOGY 147 125 $90,675 $725 8.9% (352) 726-9707
3 JOHNS HOPKINS UNIVERSITY BALTIMORE MD NURSE PRACTITIONER 2900 124 $253,084 $2,041 20.3% (410) 502-4340
4 PHYSICIANS REFERRAL SERVICE HOUSTON TX NURSE PRACTITIONER 2696 117 $370,399 $3,166 19.7% (713) 592-5433
5 NORTHWESTERN MEDICAL FACULTY FOUNDATION CHICAGO IL NURSE PRACTITIONER 4339 108 $220,860 $2,045 15.9% —
That's the top 5 of 219 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 →