NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
66175 Dilation of fluid outflow drainage within eye with insertion of device to maintain open channel CPT · Eye procedure
Classification Procedure › Eye › Fluid Flow and Drainage of Eye (Any Method) (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 156 services ▼ 52.3% YoY · 100 beneficiaries (CY2024, Medicare FFS)
Medicare paid $112K · $718.84 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 all-Medicare svcs · est.

257

Scaled from 125 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-51.1%

All-Medicare est. · observed FFS -52.3%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~257 services

125 observed fee-for-service (49%) · ~132 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 — 66175 (CY2024)
NY 76 OR 61 NJ 19

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
$240K
Named-group allowed amount
$84K
Named-group Medicare payments
$67K
Avg charge / svc
$1,918
Avg allowed / svc
$669
Avg payment / svc
$536
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
$834 4 groups · avg submitted charge / service $2,900
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 66175 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 RAMAPO OPHTHALMOLOGY ASSOCIATES, LLP POMONA NY OPHTHALMOLOGY 3 48 $99,000 $2,062 63.2% (845) 362-1450
2 CATARACT AND LASER INSTITUTE OF SOUTHERN OREGON PC MEDFORD OR OPHTHALMOLOGY 5 30 $87,000 $2,900 49.2% (541) 779-2020
3 OPTUM MEDICAL CARE PC MOUNT KISCO NY INTERNAL MEDICINE 1040 28 $23,347 $834 36.8% (914) 241-1050
4 ADRIAN W JACHENS MD LLC WAYNE NJ OPHTHALMOLOGY 3 19 $30,372 $1,599 100.0% (973) 295-5200

*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 →