NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
0250U Gene analysis of 505 genes associated with solid organ cancer in tumor tissue sample, targeted genomic sequence interrogation for somatic alterations, microsatellite instability and tumor-mutation burden HCPCS · Molecular Testing
Classification Test › Molecular Testing › Genetic Analysis (CMS RBCS)
First observed 2022
National scale 481 services · est. ▼ 3.3% YoY · 238 FFS beneficiaries (CY2024, all-Medicare estimate) — 240 observed fee-for-service services
Medicare paid $1.4M · est. · $2861.21 avg / service, national — $687K observed FFS
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

1

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

273

Scaled from 136 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-3.2%

All-Medicare est. · observed FFS -6.6%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~273 services

136 observed fee-for-service (50%) · ~137 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 — 0250U (CY2024)
TN 286 IL 154 TX 34

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
$675K
Named-group allowed amount
$389K
Named-group Medicare payments
$780K · est.
— $389K observed FFS
Avg charge / svc
$4,964
Avg allowed / svc
$2,861
Avg payment / svc
$2,861
Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 0250U svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 TENNESSEE ONCOLOGY PLLC NASHVILLE TN HEMATOLOGY/ONCOLOGY 360 136 $675,104 $4,964 100.0% (615) 385-3751

*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 →