NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
61154 Burr hole with removal and/or drainage of blood accumulation outside or below brain membrane 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 64 services ▲ 8.5% YoY · 62 beneficiaries (CY2024, Medicare FFS)
Medicare paid $86K · $1341.31 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

4

Named groups billing this code
Named-group FFS services

49

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+8.5%

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

~104 services

49 observed fee-for-service (47%) · ~55 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 — 61154 (CY2024)
IL 15 CA 14 FL 13 CO 11 NY 11

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
$568K
Named-group allowed amount
$81K
Named-group Medicare payments
$65K
Avg charge / svc
$11,597
Avg allowed / svc
$1,650
Avg payment / svc
$1,323
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
$3,712 4 groups · avg submitted charge / service $35,259
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 61154 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 ST BERNARDS PHYSICIAN CLINICS INC JONESBORO CA NURSE PRACTITIONER 206 14 $75,341 $5,381 100.0% (870) 972-8181
2 LYERLY BAPTIST INC JACKSONVILLE FL NURSE PRACTITIONER 68 13 $48,258 $3,712 100.0% (904) 388-6518
3 TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK NEW YORK NY NURSE PRACTITIONER 2273 11 $387,849 $35,259 100.0% (212) 305-8559
4 NEURO ON CALL PLLC ENGLEWOOD CO PHYSICIAN ASSISTANT 10 11 $56,804 $5,164 100.0% (303) 783-8844

*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 →