NEVVI Medicare utilization intelligence
+ Build a code basket
Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
G0238 Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring) HCPCS · Treatment - Miscellaneous
Classification Treatment › Treatment - Miscellaneous (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 146,499 services · est. ▲ 35.9% YoY · 714 FFS beneficiaries (CY2024, all-Medicare estimate) — 73,069 observed fee-for-service services
Medicare paid $1.2M · est. · $8.29 avg / service, national — $606K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

12

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

132,627

Scaled from 66,150 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+35.9%

All-Medicare est. · observed FFS +31.2%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~132,627 services

66,150 observed fee-for-service (50%) · ~66,477 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 — G0238 (CY2024)
IL 96,976 NV 16,398 NJ 5,397 NY 5,234 NM 2,593

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
$2.9M
Named-group allowed amount
$694K
Named-group Medicare payments
$1.1M · est.
— $547K observed FFS
Avg charge / svc
$43
Avg allowed / svc
$10
Avg payment / svc
$8
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
$3 12 groups · avg submitted charge / service $403
Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — each panel renders gated on the free tier.

See it in full: nuclear heart imaging (78452) in Arizona is open as a live example — every paid panel, on real data.

View the live example →
See the Platform — the full read, every number below, code baskets, and export. Notify me at launch →
Refine: group size any 5+ 25+ 100+ independent only
Filter results:

Email me this CSV

Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers G0238 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 MIDWEST PULMONARY CRITICAL CARE AND SLEEP CONSULTANTS LLC PALOS HEIGHTS IL PULMONARY DISEASE 33 55,462 $2,218,636 $40 100.0% (708) 371-8006
2 HUDSON MD GROUP FORT LEE NJ INTERNAL MEDICINE 107 3,222 $64,440 $20 100.0% (201) 224-0011
3 SPRING MOUNTAIN REHAB LLC LAS VEGAS NV PHYSICAL THERAPIST IN PRIVATE PRACTICE 6 2,970 $163,350 $55 36.8% (702) 869-4401
4 NEW HEART, INC ALBUQUERQUE NM CARDIAC ELECTROPHYSIOLOGY 2 1,304 $4,231 $3 100.0% (505) 881-8195
5 EISENHOWER MEDICAL CENTER RANCHO MIRAGE CA NURSE PRACTITIONER 457 788 $317,464 $403 100.0% (760) 340-3911
That's the top 5 of 12 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 →