NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
65920 Removal of implanted lens of eye CPT · Eye procedure
Classification Procedure › Eye (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 498 services · est. ▼ 8.9% YoY · 240 FFS beneficiaries (CY2024, all-Medicare estimate) — 244 observed fee-for-service services
Medicare paid $237K · est. · $472.59 avg / service, national — $115K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

3

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

75

Scaled from 42 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-9.0%

All-Medicare est. · observed FFS -11.6%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~75 services

42 observed fee-for-service (56%) · ~33 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 — 65920 (CY2024)
CA 179 OH 75 TX 49 IN 41 IL 40

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
$98K
Named-group allowed amount
$17K
Named-group Medicare payments
$25K · est.
— $14K observed FFS
Avg charge / svc
$2,333
Avg allowed / svc
$414
Avg payment / svc
$332
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
$840 3 groups · avg submitted charge / service $3,209
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 65920 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 STATE UNIVERSITY OF IOWA IOWA CITY IA PHYSICIAN ASSISTANT 1902 15 $48,129 $3,209 100.0% (319) 678-8201
2 MEHRAN TABAN MD INC TORRANCE CA OPHTHALMOLOGY 2 15 $39,765 $2,651 17.0% (424) 247-9090
3 WHEATON EYE CLINIC LTD WHEATON IL OPHTHALMOLOGY 45 12 $10,086 $840 52.2% (630) 668-8250

*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 →