Medicare procedure market data by CPT code & state

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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

36430 Transfusion of blood or blood products CPT · 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 2,855 services ▼ 27.8% YoY · 1,408 beneficiaries (CY2024, Medicare FFS)

Medicare paid $97K · $33.88 avg / service, national

CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window

Billing groups

Named-group FFS services

2,214

FFS of Medicare

49%

Services YoY

-27.8%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~4,537 services

2,214 observed fee-for-service (49%) · ~2,323 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 — 36430 (CY2024)

FL 616 MO 524 MD 515 CA 496 NY 210

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

Named-group submitted charges

$345K

Named-group allowed amount

$95K

Named-group Medicare payments

$76K

Avg charge / svc

$156

Avg allowed / svc

$43

Avg payment / svc

$34

Average charge per group

$77–126

$126–174

$174–223

$223–271

$271–320

$320–368

$368–417

$417+

$77 12 groups · avg submitted charge / service $510

Market analyticsPlatform

a taste of the twelve-year trend layer

Market position — where this market sits on volume and growth among all state markets, and its rank.
Worth a look — every state market for this search, ranked by a published score: size, growth, fragmentation, below-expected volume.
Lookalike opportunities — groups billing below what peers of the same specialty, size, and state predict, with the expected figure shown.
National benchmarks — where each group's volume sits nationally and within its specialty.
Market structure — how concentrated this market is, and who owns the volume.
Medicare-wide scaling — the payer split, and this market total scaled to all of Medicare, labeled as an estimate.

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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Nevvi's market analytics platform — code baskets, market structure and share, the twelve-year trend layer — is built and not launched yet. We're gathering interest in it.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by 36430 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	36430 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	HEALTH FIRST MEDICAL GROUP, LLC	MELBOURNE	FL	NURSE PRACTITIONER	669	595	$47,285	$79	premium	96.6%	(321) 434-8878
2	WASHINGTON UNIVERSITY	SAINT LOUIS	MO	NURSE PRACTITIONER	3070	496	$116,560	$235	premium	94.7%	(314) 747-3000
3	SCRIPPS HEALTH	LA JOLLA	CA	PHYSICIAN ASSISTANT	1431	386	$60,783	$157	premium	77.8%	(858) 455-9100
4	GREATER BALTIMORE MEDICAL CENTER INC	BALTIMORE	MD	HOSPITALIST	348	234	$21,114	$90	premium	45.4%	—
5	BOSTON CHILDREN'S HEALTH PHYSICIANS LLP	HAWTHORNE	NY	PEDIATRIC MEDICINE	78	143	$15,730	$110	premium	68.1%	(914) 493-7701
6	EASTERN CONNECTICUT HEMATOLOGY AND ONCOLOGY ASSOCIATES PC	NORWICH	CT	NURSE PRACTITIONER	13	103	$13,493	$131	premium	62.4%	(860) 886-8362
7	FREDERICK HEALTH MEDICAL GROUP LLC	FREDERICK	MD	PHYSICIAN ASSISTANT	202	83	$6,735	$81	premium	16.1%	(240) 215-6310
8	MONTEFIORE MEDICAL CENTER	BRONX	NY	PHYSICAL THERAPIST IN PRIVATE PRACTICE	2796	67	$34,170	$510	premium	31.9%	(866) 633-8255
9	MAYO CLINIC	ROCHESTER	MN	NURSE PRACTITIONER	4896	46	$19,734	$429	premium	27.4%	(507) 284-2511
10	LEE HEALTH SYSTEM INC	FORT MYERS	FL	NURSE PRACTITIONER	1370	21	$1,621	$77	premium	3.4%	(239) 343-9888
11	SUTTER BAY MEDICAL FOUNDATION	PALO ALTO	CA	INTERNAL MEDICINE	3716	20	$4,280	$214	premium	4.0%	(415) 600-1020
12	AFFINITY PHYSICIANS LLC.	WARWICK	RI	PHYSICIAN ASSISTANT	719	20	$3,149	$157	premium	100.0%	—

*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 →