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Market snapshot

J0179 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

J0179 — Injection, brolucizumab-dbll, 1 mg

Billing groups
18
Named-group FFS services
12,706
FFS of Medicare
49%
Services YoY
-48.7%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~24,560 services

12,706 observed fee-for-service (52%) · ~11,854 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 — J0179 (CY2024)

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

Named-group submitted charges
$7.7M
Named-group allowed amount
$4.1M
Named-group Medicare payments
$3.3M
Avg charge / svc
$608
Avg allowed / svc
$323
Avg payment / svc
$256
Average charge per group
$360 18 groups · avg submitted charge / service $1,291
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by J0179 services, CY2024
#Physician group City St Specialty Providers J0179 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 1960 EYE SURGEONS, P.A. HOUSTON TX OPHTHALMOLOGY 6 3,686 $1,540,000 $418 premium 83.1% (281) 890-1784
2 TRINITY HEALTH MINOT ND NURSE PRACTITIONER 296 1,674 $2,161,636 $1,291 premium 100.0% (701) 418-8000
3 VITREO-RETINAL CONSULTANTS AND SURGEONS PA WICHITA KS OPHTHALMOLOGY 5 906 $362,400 $400 premium 100.0% (316) 683-5611
4 MONMOUTH RETINA CONSULTANTS PA LITTLE SILVER NJ OPHTHALMOLOGY 11 792 $285,120 $360 premium 100.0% (732) 530-7730
5 RETINA AND VITREOUS CENTER PC NORFOLK VA OPHTHALMOLOGY 7 612 $258,860 $423 premium 100.0% (757) 481-4400
6 GUTHRIE MEDICAL GROUP PC SAYRE PA PHYSICIAN ASSISTANT 804 600 $392,892 $655 premium 100.0% (570) 888-5858
7 ROBERT E. TORTI, MD, PA DESOTO TX OPHTHALMOLOGY 5 564 $239,700 $425 premium 12.7% (972) 283-1516
8 CEI PHYSICIANS PSC, LLC BLUE ASH OH OPHTHALMOLOGY 157 564 $716,280 $1,270 premium 45.0% 51398451333741
9 EYE CARE SPECIALISTS LLC CAPE GIRARDEAU MO OPHTHALMOLOGY 6 516 $222,743 $432 premium 100.0% (573) 335-3577
10 CAPE FEAR RETINAL ASSOCIATES PC WILMINGTON NC OPHTHALMOLOGY 5 432 $239,760 $555 premium 100.0% (910) 332-3560
11 WOLFE CLINIC INC MARSHALLTOWN IA OPHTHALMOLOGY 36 408 $244,800 $600 premium 100.0% (641) 754-6200
12 GLACIER EYE CLINIC PC KALISPELL MT OPHTHALMOLOGY 11 384 $144,485 $376 premium 100.0% (406) 257-2020
13 TRI-STATE CENTERS FOR SIGHT INC CRESTVIEW HILLS OH OPHTHALMOLOGY 39 366 $225,822 $617 premium 29.2% (859) 341-4525
14 RETINA VITREOUS CONSULTANTS FT LAUDERDALE FL OPHTHALMOLOGY 44 312 $249,898 $801 premium 43.2% (954) 776-6880
15 JOSEPH E HUMBLE AND RAYMOND HAIK PTRS WEST MONROE LA PHYSICIAN ASSISTANT 20 258 $122,550 $475 premium 100.0% (318) 325-2610
16 SOUTHERN EYE PHYSICIANS CENTER, LLC HATTIESBURG MS OPHTHALMOLOGY 3 240 $94,688 $395 premium 100.0% (601) 264-3937
17 THE EYE PHYSICIANS OF PINELLAS, PA LARGO FL OPHTHALMOLOGY 39 206 $87,550 $425 premium 28.5% (727) 581-8706
18 TEXAS RETINA ASSOCIATES DALLAS TX OPHTHALMOLOGY 18 186 $139,500 $750 premium 4.2% (214) 692-6941

*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 →