NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
78469 Nuclear medicine study of heart muscle following heart attack with spect CPT · Nuclear imaging
Classification Imaging › Nuclear › Myocardial Perfusion Scan (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 585 services ▼ 4.6% YoY · 583 beneficiaries (CY2024, Medicare FFS)
Medicare paid $65K · $111.31 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

5

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

1,145

Scaled from 558 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+1.0%

All-Medicare est. · observed FFS -4.6%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~1,145 services

558 observed fee-for-service (49%) · ~587 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 — 78469 (CY2024)
NY 399 CA 131 TX 26 NJ 16 KS 13

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
$368K
Named-group allowed amount
$81K
Named-group Medicare payments
$64K
Avg charge / svc
$660
Avg allowed / svc
$144
Avg payment / svc
$115
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
$113 5 groups · avg submitted charge / service $806
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 78469 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 NORTHWELL HEALTHCARE INC SEAFORD NY CARDIOVASCULAR DISEASE (CARDIOLOGY) 17 372 $299,832 $806 93.2% (516) 809-4200
2 CEDARS-SINAI MEDICAL CENTER WEST HOLLYWOOD CA NURSE PRACTITIONER 802 131 $61,308 $468 100.0% (310) 423-3277
3 UTMB FACULTY GROUP PRACTICE GALVESTON TX NURSE PRACTITIONER 1068 26 $2,938 $113 100.0% (409) 772-2222
4 MEDICAL ASSOCIATES OF ENGLEWOOD PC ENGLEWOOD NJ INTERNAL MEDICINE 550 16 $2,400 $150 100.0% (201) 894-3158
5 MIDWEST HEART AND VASCULAR SPECIALISTS LLC OVERLAND PARK KS CARDIOVASCULAR DISEASE (CARDIOLOGY) 81 13 $1,859 $143 100.0% (816) 523-7088

*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 →