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

36512 Mechanical separation of red blood cells from blood 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 1,126 services ▲ 8.9% YoY · 464 beneficiaries (CY2024, Medicare FFS)

Medicare paid $86K · $76.50 avg / service, national

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

Billing groups

Named-group FFS services

1,050

FFS of Medicare

49%

Services YoY

+8.9%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~2,050 services

1,050 observed fee-for-service (51%) · ~1,000 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 — 36512 (CY2024)

MD 281 PA 139 NC 129 MI 119 CA 118

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

Named-group submitted charges

$427K

Named-group allowed amount

$107K

Named-group Medicare payments

$80K

Avg charge / svc

$407

Avg allowed / svc

$102

Avg payment / svc

$76

Average charge per group

$212–266

$266–320

$320–375

$375–429

$429–483

$483–538

$538–592

$592+

$212 13 groups · avg submitted charge / service $717

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 36512 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	36512 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	JOHNS HOPKINS UNIVERSITY	BALTIMORE	MD	NURSE PRACTITIONER	2900	281	$102,003	$363	premium	100.0%	(410) 502-4340
2	UNIVERSITY OF PENN - MEDICAL GROUP	PHILADELPHIA	PA	PHYSICIAN ASSISTANT	3505	139	$69,500	$500	premium	100.0%	(215) 662-2777
3	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	CHAPEL HILL	NC	NURSE PRACTITIONER	2120	110	$42,900	$390	premium	85.3%	(984) 215-5556
4	UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION, PC	BIRMINGHAM	AL	NURSE PRACTITIONER	2788	77	$25,025	$325	premium	100.0%	(205) 934-3460
5	UNIVERSITY MEDICAL ASSOCIATES OF THE MEDICAL UNIVERSITY OF SOUTH CAROL	CHARLESTON	SC	PHYSICIAN ASSISTANT	1692	67	$48,058	$717	premium	100.0%	(843) 792-1414
6	BARBARA ANN KARMANOS CANCER INSTITUTE	DETROIT	MI	DIAGNOSTIC RADIOLOGY	57	64	$20,695	$323	premium	53.8%	(800) 527-6266
7	UNIVERSITY PHYSICIAN GROUP	DETROIT	MI	NURSE PRACTITIONER	405	55	$11,649	$212	premium	46.2%	(800) 527-6266
8	UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION, PC	BIRMINGHAM	WA	NURSE PRACTITIONER	2788	52	$16,900	$325	premium	100.0%	(205) 934-3460
9	THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS	CHICAGO	IL	NURSE PRACTITIONER	1170	45	$26,965	$599	premium	100.0%	—
10	WASHINGTON UNIVERSITY	SAINT LOUIS	MO	NURSE PRACTITIONER	3070	44	$14,520	$330	premium	64.7%	(314) 747-3000
11	EPIC CARE	PLEASANT HILL	CA	HEMATOLOGY/ONCOLOGY	54	42	$18,522	$441	premium	35.6%	(925) 687-2570
12	UT MEDICAL GROUP INC	MEMPHIS	TN	NEPHROLOGY	95	31	$15,190	$490	premium	100.0%	(901) 866-8810
13	KOTEL ATX	AUSTIN	MO	NURSE PRACTITIONER	26	24	$7,920	$330	premium	35.3%	(512) 777-2591
14	DUKE HEALTH INTEGRATED PRACTICE INC	DURHAM	NC	PHYSICIAN ASSISTANT	3051	19	$7,410	$390	premium	14.7%	(919) 684-8111

*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 →