NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2023

Medicare Part B FFS · CY2023 · as published by CMS
83993 Stool calprotectin (protein) level CPT · General Laboratory test
Classification Test › General Laboratory › Clinical Chemistry (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 128,659 services ▲ 17.3% YoY · 116,564 beneficiaries (CY2024, Medicare FFS)
Medicare paid $2.5M · $19.22 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 FFS services

1,565

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+17.3%

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

~2,244 services

1,565 observed fee-for-service (70%) · ~679 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. How we scale
Top states — 83993 (CY2024)
NJ 27,625 NC 27,073 CA 9,694 FL 7,891 GA 7,126

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
$150K
Named-group allowed amount
$30K
Named-group Medicare payments
$30K
Avg charge / svc
$96
Avg allowed / svc
$19
Avg payment / svc
$19
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
$81 5 groups · avg submitted charge / service $100
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 83993 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 CAPITAL DIGESTIVE CARE LLC WASHINGTON MD GASTROENTEROLOGY 238 1,084 $108,400 $100 43.1% (202) 296-3449
2 SUMMIT MEDICAL GROUP PA BERKELEY HEIGHTS NJ PHYSICIAN ASSISTANT 1183 296 $23,976 $81 1.2% (908) 273-4300
3 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 118 $11,800 $100 5.9% —
4 VANGUARD MEDICAL GROUP PA VERONA NJ PHYSICIAN ASSISTANT 58 37 $2,997 $81 0.2% (973) 239-2600
5 SUMMIT MEDICAL GROUP PA BERKELEY HEIGHTS CA PHYSICIAN ASSISTANT 1183 18 $1,458 $81 0.2% (908) 273-4300
6 THE MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP HERSHEY NJ PHYSICIAN ASSISTANT 1599 12 $972 $81 0.0% (717) 531-5638

*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 →