NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
J1171 Injection, hydromorphone, 0.1 mg HCPCS · Treatment
Classification Treatment › Injections and Infusions (nononcologic) (CMS RBCS)
First observed 2024
National scale 848,944 services · est. · 229 FFS beneficiaries (CY2024, all-Medicare estimate) — 423,427 observed fee-for-service services
Medicare paid $55K · est. · $0.06 avg / service, national — $27K observed FFS
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.

606,429

Scaled from 302,468 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services YoY

—

Estimated all-Medicare volume estimate
FFS + estimated MA

~606,429 services

302,468 observed fee-for-service (50%) · ~303,961 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 — J1171 (CY2024)
KY 731,658 AZ 101,165 NV 38,207 FL 28,123 CA 1,968

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
$130K
Named-group allowed amount
$24K
Named-group Medicare payments
$39K · est.
— $19K observed FFS
Avg charge / svc
$0
Avg allowed / svc
$0
Avg payment / svc
$0
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
$0 5 groups · avg submitted charge / service $5
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers J1171 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 COMMONWEALTH PAIN ASSOCIATES PLLC LOUISVILLE KY NURSE PRACTITIONER 159 221,797 $55,449 $0 65.2% (502) 855-7200
2 PIONEER SPORTS AND SPINE PLLC GILBERT AZ NURSE PRACTITIONER 2 50,260 $67,390 $1 100.0% (480) 249-5525
3 BERMAN AND PITMAN LTD RENO NV NURSE PRACTITIONER 12 18,817 $1,581 $0 100.0% (775) 689-5410
4 FOUNDATION FOR SICKLE CELL DISEASE RESEARCH HOMESTEAD FL HEMATOLOGY/ONCOLOGY 4 11,484 $4,823 $0 93.1% (954) 397-3251
5 COLORADO SPRINGS INTERVENTIONAL PAIN MANAGEMENT PC COLORADO SPGS CO INTERVENTIONAL PAIN MANAGEMENT 3 110 $550 $5 100.0% (719) 228-9440

*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 →