NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
67412 Removal of growth of cavity behind eye CPT · Eye procedure
Classification Procedure › Eye (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 650 services · est. ▲ 27.6% YoY · 295 FFS beneficiaries (CY2024, all-Medicare estimate) — 324 observed fee-for-service services
Medicare paid $556K · est. · $856.49 avg / service, national — $278K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

7

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

479

Scaled from 239 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+27.7%

All-Medicare est. · observed FFS +23.2%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~479 services

239 observed fee-for-service (50%) · ~240 estimated Medicare Advantage.

Billing for this code concentrates in one state — scaled by the national payer mix (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale
Top states — 67412 (CY2024)
FL 465 IN 49 NY 36 MI 34 MD 33

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
$1.1M
Named-group allowed amount
$300K
Named-group Medicare payments
$479K · est.
— $239K observed FFS
Avg charge / svc
$4,492
Avg allowed / svc
$1,253
Avg payment / svc
$1,001
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
$1,110 7 groups · avg submitted charge / service $11,610
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 67412 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 GREGORY L HENDERSON MD FACS INC BRANDON FL OPHTHALMOLOGY 32 147 $790,062 $5,375 72.1% —
2 OPHTHALMIC PLASTIC SURGERY INC CARMEL IN OPHTHALMOLOGY 6 25 $28,232 $1,129 100.0% (317) 817-1976
3 MIKE S. MCFARLAND MDPA LITTLE ROCK AR OPTOMETRY 14 15 $27,030 $1,802 100.0% (501) 830-2020
4 OPHTHALMIC PLASTIC AND ORBITAL CONSULTANTS PC BETHESDA MD OPHTHALMOLOGY 2 14 $41,300 $2,950 56.0% (301) 571-0000
5 KEITH GURLAND MD BAYONNE NJ OPHTHALMOLOGY 2 13 $14,431 $1,110 100.0% (201) 339-1266
That's the top 5 of 7 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 →