NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2023

Medicare Part B FFS · CY2023 · as published by CMS
68761 Closure of tear duct opening using plug CPT · Eye procedure
Classification Procedure › Eye (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 444,095 services ▲ 10.9% YoY · 175,552 beneficiaries (CY2024, Medicare FFS)
Medicare paid $46.2M · $104.01 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

1,262

Named groups billing this code
Named-group FFS services

255,113

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+10.9%

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

~506,837 services

255,113 observed fee-for-service (50%) · ~251,724 estimated Medicare Advantage.

Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2023) — scaled estimate — assumes MA utilization mirrors FFS; not an observation; 1 state without payer-mix data excluded. How we scale
Top states — 68761 (CY2024)
CA 108,156 FL 79,515 NY 52,627 AZ 18,609 NJ 17,080

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
$91.8M
Named-group allowed amount
$36.4M
Named-group Medicare payments
$27.8M
Avg charge / svc
$360
Avg allowed / svc
$143
Avg payment / svc
$109
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
$96 1,262 groups · avg submitted charge / service $1,676
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 68761 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 RIDGE EYE CARE INC MARYSVILLE CA OPTOMETRY 19 22,238 $5,403,834 $243 22.5% (530) 743-1873
2 EYE OF HORUS PA BOCA RATON FL OPHTHALMOLOGY 3 6,353 $1,637,771 $258 8.6% (561) 488-1001
3 EYES ON SITE PLLC MESA AZ OPTOMETRY 4 4,131 $763,937 $185 29.9% (480) 626-8925
4 ATLANTIC EYE INSTITUTE, P.A. JACKSONVILLE FL OPHTHALMOLOGY 10 3,288 $1,306,800 $397 4.5% (904) 241-7865
5 FLORIDA EYE MICROSURGICAL INSTITUTE INC BOYNTON BEACH FL OPHTHALMOLOGY 13 2,793 $852,174 $305 3.8% (561) 737-5500
That's the top 5 of 1,262 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. 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 →