NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
G0316 Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by th HCPCS · E&M
Classification E&M Hospital Inpatient Services Hospital E&M - Subsequent (CMS RBCS)
First observed 2023
National scale 815,371 services · est. ▲ 63.9% YoY · 165,025 FFS beneficiaries (CY2024, all-Medicare estimate) — 399,984 observed fee-for-service services
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Data year CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Market overview
Market Brief G0316
The whole of G0316, written up and sourced.

The Brief is a national document for G0316. Its findings page carries one finding per chapter, each opening the chapter that prints its figure and the table behind it — like these, from the United States, CY2024, the market on this page.

  1. 1Size and growth. The national market for G0316 ran ~815,371 all-Medicare services (estimated), 399,984 observed fee-for-service in CY2024. The market is up 63.9% year over year. 738 billing groups and 5,098 clinicians bill it.
  2. 2Payment. Half the field lists between $68 and $121 per service; the median group lists $89. Submitted charges are provider-set list amounts, not payments.
  3. 3Geography. CA, PA, IL and TX lead the state markets — together 35% of state-market volume.
Estimated all-Medicare volume estimate
FFS + estimated MA

~815,371 services

399,984 observed fee-for-service (49%) · ~415,387 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
Average charge
per service, submitted list amounts — not payments · named-group basis, observed FFS
Average payment
per service, Medicare paid amounts — not charges · all disclosed claims, observed FFS basis
Charge-to-payment ratio
average list price vs average Medicare payment per service · named-group basis
What they charge

Half the field lists between $68 and $121

Submitted charges are provider-set list amounts, not payments · median $89 (named groups)
Every group, one dot738 billing groups · median $89

The same field as one dot per billing group: where the cluster sits, and how far the tail reaches

$0$125$250++33 groups list more, to $735 →average submitted charge per service, per billing groupmedian $89
One dot per billing group, G0316 nationwide CY2024 — average submitted charge per service, provider-set list amounts, not payments. The axis caps near the 95th percentile so the cluster is legible; groups beyond it draw at the cap in accent and are counted on the chart.
Where the market isobserved FFS services by state · CY2024
ME: 4000MEVT: 1368VTNH: 2209NHWA: 9110WAID: 1921IDMT: 1510MTND: 343NDMN: 12171MNWI: 12453WIIL: 26674ILMI: 14670MINY: 14326NYMA: 10513MARI: 1880RIOR: 12241ORNV: 4014NVWY: 235WYSD: 2127SDIA: 2143IAIN: 4962INOH: 3036OHPA: 27538PANJ: 2356NJCT: 1848CTCA: 59682CAUT: 12959UTCO: 7820CONE: 993NEMO: 7836MOKY: 2158KYWV: 346WVVA: 7165VAMD: 17770MDDE: 1075DEAZ: 7177AZNM: 908NMKS: 3052KSAR: 1443ARTN: 4376TNNC: 8616NCSC: 4002SCDC: 1987DCOK: 690OKLA: 2614LAMS: 64MSAL: 2405ALGA: 24663GAHI: 2350HIAK: 165AKTX: 25534TXFL: 18486FL
Shaded low→high on observed fee-for-service services billed from each state · the /stats tile grid, at national scope. Shading ranks the states rather than spacing them along the range, so neighboring shades mean adjacent RANKS, not equal gaps — the key names the lowest and highest; each tile carries its own figure.

Open a state market: CA · PA · IL · TX · GA · FL · MD · MI · NY · UT · WI · OR — the group ranking lives in the Provider groups tab. Territories bill too; the tile grid draws the 50 states and DC.

Every group in this market, placed by list charge against volume

This market’s groups, on one chart738 groups · bubble = services
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One mark per physician group, G0316 nationwide CY2024 — marks are unnamed here: a mark’s position is its average list charge, and that figure is part of the platform. Submitted charges are provider-set list amounts, not payments.

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