NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
P9016 Red blood cells, leukocytes reduced, each unit HCPCS · Hematology procedure
Classification Procedure › Hematology › Red Blood Cell Transfusion (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 1,649 services ▼ 17.1% YoY · 619 beneficiaries (CY2024, Medicare FFS)
Medicare paid $161K · $97.70 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

951

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-17.1%

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

~1,806 services

951 observed fee-for-service (53%) · ~855 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 — P9016 (CY2024)
FL 559 MD 535 CA 505 IL 31 MO 19

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
$597K
Named-group allowed amount
$66K
Named-group Medicare payments
$52K
Avg charge / svc
$628
Avg allowed / svc
$69
Avg payment / svc
$55
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
$301 5 groups · avg submitted charge / service $842
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers P9016 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 HEALTH FIRST MEDICAL GROUP, LLC MELBOURNE FL NURSE PRACTITIONER 669 536 $301,740 $563 95.9% (321) 434-8878
2 GREATER BALTIMORE MEDICAL CENTER INC BALTIMORE MD HOSPITALIST 348 302 $254,400 $842 56.4% —
3 FREDERICK HEALTH MEDICAL GROUP LLC FREDERICK MD PHYSICIAN ASSISTANT 202 71 $21,372 $301 13.3% (240) 215-6310
4 LEE HEALTH SYSTEM INC FORT MYERS FL NURSE PRACTITIONER 1370 23 $12,972 $564 4.1% (239) 343-9888
5 WASHINGTON UNIVERSITY SAINT LOUIS MO NURSE PRACTITIONER 3070 19 $6,365 $335 100.0% (314) 747-3000

*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 →