NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
68700 Plastic repair of tear duct CPT · Eye procedure
Classification Procedure Eye (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 1,001 services ▼ 2.7% YoY · 854 beneficiaries (CY2024, Medicare FFS)
Medicare paid $467K · $466.99 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
18
Named-group FFS services
348
FFS of Medicare
49%
Services YoY
-2.7%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~699 services

348 observed fee-for-service (50%) · ~351 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 — 68700 (CY2024)

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Named-group submitted charges
$757K
Named-group allowed amount
$196K
Named-group Medicare payments
$156K
Avg charge / svc
$2,176
Avg allowed / svc
$564
Avg payment / svc
$448
Average charge per group
$1,092 18 groups · avg submitted charge / service $4,328
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 68700 services, highest first, CY2024
# Physician group activate to sort City activate to sort St activate to sort Specialty activate to sort Providers activate to sort 68700 svcs sorted descending — activate to reverse Submitted charges activate to sort Avg charge activate to sort Medicare $ locked column Share* activate to sort Phone
1 FACIAL AND OCULOPLASTIC SURGERY CENTER OF TEXAS PLLC SAN ANTONIO TX OPHTHALMOLOGY 6 40 $85,092 $2,127 premium 30.1% (210) 495-2367
2 MORGENSTERN CENTER FOR ORBITAL AND FACIAL PLASTIC SURGERY, INC WAYNE PA PHYSICIAN ASSISTANT 4 35 $74,739 $2,135 premium 26.3% (610) 687-8771
3 JACKSON EYE ASSOCIATES PLLC MADISON MS OPHTHALMOLOGY 13 32 $77,220 $2,413 premium 35.6% (601) 353-2020
4 EYE SPECIALISTS OF ILLINOIS SC PARK RIDGE IL OPHTHALMOLOGY 5 29 $81,488 $2,810 premium 37.2%
5 SPRINGFIELD CLINIC, LLP SPRINGFIELD IL NURSE PRACTITIONER 686 26 $112,518 $4,328 premium 33.3% (217) 544-6464
6 1960 EYE SURGEONS, P.A. HOUSTON TX OPHTHALMOLOGY 6 23 $25,500 $1,109 premium 17.3% (281) 890-1784
7 OPHTHALMIC CONSULTANTS OF LONG ISLAND ROCKVILLE CENTRE NY OPHTHALMOLOGY 107 18 $42,000 $2,333 premium 8.3% (516) 766-2519
8 OPHTHALMIC PLASTIC SURGERY SPECIALISTS PLLC JACKSON MS OPHTHALMOLOGY 2 16 $21,300 $1,331 premium 17.8% (601) 355-9537
9 CONSULTANTS IN OPHTHALMIC AND FACIAL PLASTIC SURGERY SOUTHFIELD MI OPHTHALMOLOGY 9 15 $16,376 $1,092 premium 42.9% (248) 357-5100
10 UNIVERSITY PHYSICIANS OF BROOKLYN, INC. BROOKLYN NY OPHTHALMOLOGY 171 15 $32,355 $2,157 premium 6.9% (718) 270-1714
11 OPHTHALMIC PLASTIC SURGERY PLLC SLINGERLANDS NY OPHTHALMOLOGY 5 14 $19,800 $1,414 premium 6.5% (518) 533-6540
12 REMAGIN LLC WINDERMERE FL OPHTHALMOLOGY 3 14 $16,909 $1,208 premium 100.0% (407) 704-3937
13 TIMOTHY F. MCDEVITT, M.D. INC HONOLULU TX OPHTHALMOLOGY 3 13 $31,160 $2,397 premium 9.8% (808) 599-4755
14 TEXAS OCULOPLASTIC CONSULTANTS LLP AUSTIN TX OPHTHALMOLOGY 12 13 $26,600 $2,046 premium 9.8% (512) 457-2141
15 REGENTS OF THE UNIVERSITY OF CALIFORNIA ORANGE CA OPHTHALMOLOGY 51 12 $46,478 $3,873 premium 33.3% (714) 456-8068
16 OPHTHALMIC PLASTIC AND ORBITAL CONSULTANTS PC BETHESDA MD OPHTHALMOLOGY 2 11 $16,200 $1,473 premium 100.0% (301) 571-0000
17 WATERLOO EYE ASSOCIATES CEDAR PARK TX OPHTHALMOLOGY 4 11 $18,293 $1,663 premium 8.3% (512) 528-1144
18 AESTHETIC EYE CARE SAN LUIS OBISPO CA OPHTHALMOLOGY 2 11 $13,251 $1,205 premium 30.6% (312) 404-7237

*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 →