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

39402 Exam of chest with biopsy of lymph node using an endoscope CPT · Other Organ Systems procedure

Classification Procedure › Other Organ Systems (CMS RBCS)

First observed 2016

National scale 216 services ▼ 39.2% YoY · 216 beneficiaries (CY2024, Medicare FFS)

Medicare paid $60K · $276.68 avg / service, national

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

Billing groups

Named-group FFS services

184

FFS of Medicare

49%

Services YoY

-39.2%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~360 services

184 observed fee-for-service (51%) · ~176 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 — 39402 (CY2024)

CA 36 FL 34 IL 34 SC 29 VA 20

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

Named-group submitted charges

$265K

Named-group allowed amount

$63K

Named-group Medicare payments

$50K

Avg charge / svc

$1,442

Avg allowed / svc

$343

Avg payment / svc

$273

Average charge per group

$865–1,046

$1,046–1,227

$1,227–1,408

$1,408–1,589

$1,589–1,769

$1,769–1,950

$1,950–2,131

$2,131+

$865 10 groups · avg submitted charge / service $2,640

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 39402 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	39402 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	SIU PHYSICIANS AND SURGEONS INC	SPRINGFIELD	IL	NURSE PRACTITIONER	321	34	$45,136	$1,328	premium	100.0%	(217) 545-8000
2	SPARTANBURG MEDICAL CENTER	SPARTANBURG	SC	NURSE PRACTITIONER	1070	29	$41,845	$1,443	premium	100.0%	(864) 587-3000
3	MARY WASHINGTON HEALTHCARE PHYSICIANS	FREDERICKSBURG	VA	PHYSICIAN ASSISTANT	307	20	$18,480	$924	premium	100.0%	(540) 741-1100
4	BAPTIST HEALTH MEDICAL GROUP PHYSICIANS LLC	SOUTH MIAMI	FL	PHYSICIAN ASSISTANT	653	19	$31,567	$1,661	premium	55.9%	(786) 662-0600
5	SSM MEDICAL GROUP INC	SAINT LOUIS	MO	NURSE PRACTITIONER	547	16	$20,160	$1,260	premium	100.0%	(314) 645-6450
6	FLORIDA HOSPITAL HEALTHCARE PARTNERS, INC	DAYTONA BEACH	FL	PHYSICIAN ASSISTANT	588	15	$18,975	$1,265	premium	44.1%	(386) 231-6000
7	THE REGENTS OF THE UNIVERSITY OF CALIFORNIA	LOS ANGELES	CA	THORACIC SURGERY	12	15	$39,600	$2,640	premium	41.7%	(310) 825-9111
8	MAYO CLINIC	ROCHESTER	MN	NURSE PRACTITIONER	4896	13	$24,846	$1,911	premium	100.0%	(507) 284-2511
9	ADVENTIST HEALTH SYSTEM GEORGIA INC	CALHOUN	GA	NURSE PRACTITIONER	229	12	$15,180	$1,265	premium	100.0%	—
10	MERITUS MEDICAL CENTER INC	HAGERSTOWN	MD	NURSE PRACTITIONER	725	11	$9,515	$865	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 →