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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
0626T Review of computerized analysis of ct angiography data on plaque in heart arteries, with interpretation, and report HCPCS · CT Scan imaging
Classification Imaging CT Scan (CMS RBCS)
First observed 2024
National scale 205 services · 205 beneficiaries (CY2024, Medicare FFS)
Medicare paid $12K · $59.62 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
3
Named-group FFS services
133
FFS of Medicare
49%
Services YoY
Estimated all-Medicare volume FFS + estimated MA estimate
~281 services

133 observed fee-for-service (47%) · ~148 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 — 0626T (CY2024)

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Named-group submitted charges
$38K
Named-group allowed amount
$10K
Named-group Medicare payments
$8K
Avg charge / svc
$284
Avg allowed / svc
$75
Avg payment / svc
$60
Average charge per group
$262 3 groups · avg submitted charge / service $300
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Or just look at it: nuclear heart imaging (78452) in Arizona is open as a live example — the full paid view, real data.

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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 0626T services, highest first, CY2024
# Physician group activate to sort City activate to sort St activate to sort Specialty activate to sort Providers activate to sort 0626T svcs sorted descending — activate to reverse Submitted charges activate to sort Avg charge activate to sort Medicare $ locked column Share* activate to sort Phone
1 NATIONAL JEWISH HEALTH DENVER CO PULMONARY DISEASE 243 55 $16,500 $300 premium 51.4% (303) 398-1355
2 HEALTHTEXAS PROVIDER NETWORK DALLAS TX PHYSICIAN ASSISTANT 2482 55 $14,438 $262 premium 100.0%
3 NEW YORK UNIVERSITY NEW YORK CO DIAGNOSTIC RADIOLOGY 5704 23 $6,900 $300 premium 21.5% (212) 263-9700

*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 →