NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
67331 Realignment of eye muscle following injury or eye surgery CPT · Eye procedure
Classification Procedure › Eye (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 459 services ▲ 26.8% YoY · 447 beneficiaries (CY2024, Medicare FFS)
Medicare paid $63K · $137.51 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

14

Named groups billing this code
Named-group FFS services

356

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+26.8%

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

~720 services

356 observed fee-for-service (49%) · ~364 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 — 67331 (CY2024)
CA 130 TX 64 GA 35 AZ 28 KS 28

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
$428K
Named-group allowed amount
$60K
Named-group Medicare payments
$48K
Avg charge / svc
$1,202
Avg allowed / svc
$169
Avg payment / svc
$135
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
$399 14 groups · avg submitted charge / service $1,941
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 67331 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 SHULKIN EYE ASSOCIATES DALLAS TX OPHTHALMOLOGY 2 42 $16,757 $399 65.6% (972) 566-7999
2 SCRIPPS HEALTH LA JOLLA CA PHYSICIAN ASSISTANT 1431 39 $59,561 $1,527 30.0% (858) 455-9100
3 THOMAS EYE GROUP PC ROSWELL GA OPTOMETRY 56 35 $42,350 $1,210 100.0% (770) 475-5515
4 GRENE VISION GROUP LLC WICHITA KS OPHTHALMOLOGY 9 28 $27,115 $968 100.0% (316) 722-8883
5 PHOENIX CHILDREN'S HOSPITAL PHOENIX AZ NURSE PRACTITIONER 417 28 $34,200 $1,221 100.0% (602) 933-0930
6 REGENTS OF THE UNIVERSITY OF CALIFORNIA ORANGE CA OPHTHALMOLOGY 51 27 $51,680 $1,914 20.8% (714) 456-8068
7 SANSUM CLINIC SANTA BARBARA CA INTERNAL MEDICINE 322 27 $22,140 $820 20.8% (805) 681-7500
8 ASHEVILLE EYE ASSOCIATES PLLC ASHEVILLE NC OPHTHALMOLOGY 24 25 $16,900 $676 100.0% (828) 258-1586
9 CHILDRENS EYE SPECIALISTS LLC. LADSON SC OPHTHALMOLOGY 2 23 $44,643 $1,941 100.0% (843) 202-0288
10 VANDERBILT UNIVERSITY MEDICAL CENTER NASHVILLE TN NURSE PRACTITIONER 3394 22 $35,280 $1,604 100.0% (615) 322-5000
11 FLORIDA PEDIATRIC ASSOCIATES, LLC MAITLAND FL OPHTHALMOLOGY 35 19 $27,160 $1,429 100.0% (407) 767-6411
12 VIRGINIA OPHTHALMOLOGY ASSOCIATES PC NORFOLK VA OPHTHALMOLOGY 5 16 $14,450 $903 100.0% (757) 461-1444
13 CONESTOGA EYE PC HERSHEY PA OPTOMETRY 7 13 $18,000 $1,385 100.0% (717) 541-9700
14 PLECHA DURANT STANKO JOHNSON AND COHEN A PROFESSIONAL CORPORATION RENO NV OPHTHALMOLOGY 4 12 $17,610 $1,468 100.0% (775) 329-0286

*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 →