NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
Q2028 Injection, sculptra, 0.5 mg HCPCS · Treatment
Classification Treatment › Injections and Infusions (nononcologic) (CMS RBCS)
First observed 2014
National scale 652,266 services ▲ 42.4% YoY · 129 beneficiaries (CY2024, Medicare FFS)
Medicare paid $420K · $0.64 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

4

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

1,191,647

Scaled from 586,115 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+42.4%

All-Medicare est. · observed FFS +42.4%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~1,191,647 services

586,115 observed fee-for-service (49%) · ~605,532 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 — Q2028 (CY2024)
CA 584,646 NY 41,160 MA 26,460

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
$2.4M
Named-group allowed amount
$494K
Named-group Medicare payments
$392K
Avg charge / svc
$4
Avg allowed / svc
$1
Avg payment / svc
$1
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
$2 4 groups · avg submitted charge / service $500
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers Q2028 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 CONTOUR DERMATOLOGY AND COSMETIC SURGERY MEDICAL CENTER APC RANCHO MIRAGE CA PHYSICIAN ASSISTANT 16 473,370 $1,893,480 $4 81.0% (760) 423-4000
2 DAP HEALTH INC PALM SPRINGS CA NURSE PRACTITIONER 60 71,309 $285,236 $4 12.2% (760) 323-2118
3 ADAM GEYER MD PC NEW YORK NY DERMATOLOGY 5 41,160 $82,320 $2 100.0% (212) 374-9750
4 DAVID J. MACGREGOR, M.D., APC SAN FRANCISCO CA DERMATOLOGY 2 276 $138,000 $500 0.0% (415) 989-9400

*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 →